Z Gastroenterol 2010; 48 - P387
DOI: 10.1055/s-0030-1263827

Evaluation of new serum markers as predictors of liver fibrosis in patients with chronic liver disease irrespective of the aetiology

F Grünhage 1, J Rädle 1, T Rädle-Hurst 2, S Weidner 1, T Sauerbruch 3, G Hess 4, F Lammert 1
  • 1Saarland University Hospital, Medical Department II, Homburg, Germany
  • 2Saarland University Hospital, Department of Pediatric Cardiology, Homburg, Germany
  • 3University Hospital Bonn, Department of Internal Medicine I, Bonn, Germany
  • 4Roche Diagnostics, Grenzach-Whylen, Germany

Aims: Identification of non-invasive serum fibrosis markers in liver cirrhosis is challenging. We aimed to identify a new marker panel for the identification of significant fibrosis in a large cohort of patients with chronic liver disease with mixed aetiology.

Patients and methods: Patients were included in the study if they suffered from chronic liver disease irresprective of the aetiology. Transient elastography was employed to phenotype the patients. Significant fibrosis was defined by TE results >7.5kPa and no-fibrosis by TE results <7.5 kPa, according to previously published cut-off values. Serum levels of hsTNT, sFLT-1, PLGF, NT-proBNP, GDF-15, adiponectin, BMP-7, endoglin and HGF were determined in all patients. ROC analysis was performed to determine the predictive values for the prediction of fibrosis. Uni- and multivariate regression analyses were applied to identify independent predictors of significant fibrosis.

Results: A total number of 1050 patients were included in the study (median age 50 years, range 17–88, m:f: 648:402). The predominant liver diseases were chronic HCV infection (n=585; 55.5%), NASH (n=105; 10.5%) and alcoholic liver disease (n=105; 9.9%). Overall, 404 patients qualified for the significant fibrosis group and 515 patients for the no-fibrosis group. All tested markers, except adiponectin, were significantly correlated with unclassified TE results (p for all tests <0.0001). Thus, those significant markers were entered into a ROC analysis, showing predictive values with p<0.001. However, GDF-15 and HGF as well as PLGF achieved the highest AUC (>0.75). Multivariate regression analysis including age and the new serum markers revealed that only PLGF, endoglin and HGF were independent predictors of significant fibrosis in our cohort.

Subgroup analysis in patients with chronic HCV infection showed that patients with PLGF levels >20.8 pg/ml had the highest risk to present with significant fibrosis (RR=7.84; 95% C.I.: 5.12–12.00; p<0.001).

Conclusions: Our analysis identified a novel panel of new serum markers with promising predictive values for the identification of patients with significant fibrosis. However, further analysis is needed to clarify the predictive properties in clinical practice.