Is endocan a novel potential biomarker of liver steatosis and fibrosis? Translated title: Da li je endokan novi potencijalni biomarker za steatozu i fibrozu jetre?

Abstract

Background

Studies that evaluated endocan levels in nonalcoholic fatty liver disease (NAFLD) and liver fibrosis are scarce. We aimed to explore endocan levels in relation to different stages of liver diseases, such as NAFLD, as determined with fatty liver index (FLI) and liver fibrosis, as assessed with BARD score.

Methods

A total of 147 participants with FLI≥60 were compared with 64 participants with FLI <30. An FLI score was calculated using waist circumference, body mass index, gamma-glutamyl transferase and triglycerides. Patients with FLI≥60 were further divided into those with no/mild fibrosis (BARD score 0-1 point; n=23) and advanced fibrosis (BARD score 2-4 points; n=124). BARD score was calculated as follows: diabetes mellitus (1 point) + body mass index≥28 kg/m2 (1 point) + aspartate amino transferase/alanine aminotransferase ratio≥0.8 (2 points).

Results

Endocan was independent predictor for FLI and BARD score, both in univariate [OR=1.255 (95% CI= 1.104-1.426), P=0.001; OR=1.208 (95% CI=1.029-1.419), P=0.021, respectively] and multivariate binary logistic regression analysis [OR=1.287 (95% CI=1.055-1.570), P=0.013; OR=1.226 (95% CI=1.022-1.470), P=0.028, respectively]. Endocan as a single predictor showed poor discriminatory capability for steatosis/fibrosis [AUC=0.648; (95% CI=0.568-0.727), P=0.002; AUC= 0.667 (95% CI=0.555-0.778), P=0.013, respectively], whereas in a Model, endocan showed an excellent clinical accuracy [AUC=0.930; (95% CI=0.886-0.975), P<0.001, AUC=0.840 (95% CI=0.763-0.918), P<0.001, respectively].

Conclusions

Endocan independently correlated with both FLI and BARD score. However, when tested in models (with other biomarkers), endocan showed better discriminatory ability for liver steatosis/fibrosis, instead of its usage as a single biomarker.

Translated abstract

Uvod

Nema mnogo studija koje su ispitivale vrednosti endokana kod obolelih od nealkoholne steatoze i fibroze jetre. Na cilj je bio da se ispita nivo endokana u različitim stadijumima oboljenja jetre, kao to su nealkoholna steatoza jetre, predstavljena indeksom masne jetre (FLI) i fibroza jetre, predstavljena BARD skorom.

Metode

Ukupno 147 učesnika sa FLI≥60 poređeno je sa 64 učesnika sa FLI <30. FLI skor je izračunat koristeći vrednosti obim struka, indeksa telesne mase, aktivnosti gama-glutamil transferaze i vrednosti triglicerida. Ispitanici sa FLI≥60 su dalje podeljeni u 2 grupe: bez fibroze/blaga fibroza (BARD skor 0-1 poen; n=23) i uznapredovala fibroza (BARD skor 2-4 poena; n=124). BARD skor je računat na sledeći način: šećerna bolest (1 poen) + indeks telesne mase≥28 kg/m2 (1 poen) + odnos aspartat aminotransferaza/alanin aminotransferaza≥0,8 (2 poena).

Rezultati

Endokan je nezavisan prediktor FLI i BARD skora, kako u univarijantnoj [OR=1,255 (95% CI=1,104-1,426), P=0,001; odnosno OR=1,208 (95% CI=1,029-1,419), P=0,021], tako i u multivarijantnoj binarnoj logističkoj regresionoj analizi [OR=1.287 (95% CI=1,055-1,570), P=0,013; odnosno OR=1,226 (95% CI=1,022-1,470), P=0,028]. Endokan kao samostalan prediktor pokazao je slabu diskriminatornu moć za steatozu/fibrozu jetre [AUC=0,648; (95% CI=0,568-0,727), P=0,002; odnosno AUC=0,667 (95% CI=0,555-0,778), P=0,013], ali je u Modelu pokazao odličnu kliničku tačnost [AUC=0,930; (95% CI=0,886-0,975), P<0,001; odnosno AUC=0,840 (95% CI=0,763-0,918), P<0,001].

Zaključak

Endokan je nezavisno povezan kako sa FLI, tako i sa BARD skorom. Ipak, u modelu (sa drugim biomarkerima), endokan je pokazao bolju diskriminatornu sposobnost za steatozu/fibrozu jetre.