Quantitative measurements of M2BPGi depend on liver fibrosis and inflammation

• Published in: Journal of gastroenterology Vol. 59; no. 7; pp. 598 - 608
• Main Authors: Uojima, Haruki, Yamasaki, Kazumi, Sugiyama, Masaya, Kage, Masayoshi, Ishii, Norihiro, Shirabe, Ken, Hidaka, Hisashi, Kusano, Chika, Murakawa, Miyako, Asahina, Yasuhiro, Nishimura, Takashi, Iijima, Hiroko, Sakamoto, Kazumasa, Ito, Kiyoaki, Amano, Keisuke, Kawaguchi, Takumi, Tamaki, Nobuharu, Kurosaki, Masayuki, Suzuki, Takanori, Matsuura, Kentaro, Taketomi, Akinobu, Joshita, Satoru, Umemura, Takeji, Nishina, Sohji, Hino, Keisuke, Toyoda, Hidenori, Yatsuhashi, Hiroshi, Mizokami, Masashi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.07.2024; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Aged; Alanine transaminase; Antigens, Neoplasm - blood; Biliary Tract; Biomarkers - blood; Cholangitis; Chronic Disease; Cirrhosis; Colorectal Surgery; Disease Progression; Etiology; Fatty liver; Female; Fibrosis; Gastroenterology; Glycosylation; Hepatitis; Hepatitis C; Hepatitis, Autoimmune - blood; Hepatitis, Autoimmune - complications; Hepatitis, Autoimmune - diagnosis; Hepatitis, Autoimmune - pathology; Hepatitis, Viral, Human - complications; Hepatitis, Viral, Human - pathology; Hepatology; Humans; Inflammation; Inflammation - pathology; Liver cirrhosis; Liver Cirrhosis - blood; Liver Cirrhosis - diagnosis; Liver Cirrhosis - pathology; Liver diseases; Male; Medicine; Medicine & Public Health; Membrane Glycoproteins - blood; Middle Aged; Non-alcoholic Fatty Liver Disease - pathology; Original Article―Liver; Pancreas; Surgical Oncology; Noninvasive marker; Chronic liver disease; Liver fibrosis; Quantitative measurement; Liver inflammation
• ISSN: 0944-1174; 1435-5922; 1435-5922
• DOI: 10.1007/s00535-024-02100-3

Background The relationship between liver fibrosis and inflammation and Mac-2-binding protein glycosylation isomer (M2BPGi) in patients with chronic liver disease (CLD) other than hepatitis C remains uncertain, owing to the limitations of qualitative methods. Here, we evaluated the influence of liver fibrosis and inflammation on quantitative M2BPGi (M2BPGi-Qt) in CLD, considering each etiology. Methods We recruited 1373 patients with CLD. To evaluate the influence of liver fibrosis and inflammation on M2BPGi-Qt levels, we assessed M2BPGi-Qt levels at each fibrosis and activity stage within different etiologies of CLD based on pathological findings. Subsequently, we evaluated if the accuracy of fibrosis staging based on M2BPGi-Qt could be improved by considering the influence of liver inflammation. Results In patients with viral hepatitis, non-alcoholic fatty liver disease, and primary biliary cholangitis, the median M2BPGi-Qt levels increased liver fibrosis progression. Median M2BPGi-Qt levels were not associated with the degree of fibrosis in patients with autoimmune hepatitis (AIH). Median M2BPGi-Qt levels increased with the progression of liver activity in all etiologies. A significant difference was found at each stage in AIH. Considering the liver inflammation, we established an algorithm, M2BPGi-Qt, to determine the alanine aminotransferase-to-platelet ratio (MAP-R) in liver cirrhosis (LC). The area under the receiver operating characteristic curve (AUC) of MAP-R was higher than that of the M2BPGi-Qt for detecting LC (AUC MAP-R = 0.759 and M2BPGi-Qt = 0.700, p  < 0.001). Conclusions The quantitative measurement system for M2BPGi depends on liver fibrosis and inflammation, regardless of etiology. Liver inflammation complicates the interpretation of M2BPGi-Qt results when assessing the fibrosis stage.