Serum MFAP4, a novel potential biomarker for liver cirrhosis screening, correlates with transient elastography in NAFLD patients

• Published in: JGH open Vol. 7; no. 3; pp. 197 - 203
• Main Authors: Kanaan, Reine, Yaghi, Cesar, Saade Riachy, Carole, Schlosser, Anders, Hamade, Aline, Holmskov, Uffe, Medlej‐Hashim, Myrna, Sørensen, Grith Lykke, Jounblat, Rania
• Format: Journal Article
• Language: English
• Published: Melbourne Wiley Publishing Asia Pty Ltd 01.03.2023; John Wiley & Sons, Inc; Wiley
• Subjects: Accuracy; Alcohol; Biomarkers; Biopsy; cirrhosis; Diabetes; Hepatitis B; Hepatitis C; Liver cirrhosis; Liver diseases; Metabolism; MFAP4; non‐alcoholic fatty liver disease; Obesity; Original; Proteins; Regression analysis; serum biomarker; transient elastography; Viral infections; Lebanon; Beirut Lebanon; transient elastography; MFAP4; non‐alcoholic fatty liver disease; serum biomarker; cirrhosis
• ISSN: 2397-9070; 2397-9070
• DOI: 10.1002/jgh3.12873

Background and Aim Non‐alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in different countries. Liver fibrosis is considered as the most appropriate predictor of NAFLD‐associated outcome. Microfibrillar‐associated protein 4 (MFAP4) is a glycoprotein located in the extracellular matrix. Circulatory MFAP4 has been suggested as a noninvasive biomarker for the assessment of hepatitis C virus and alcoholic liver disease associated liver fibrosis. In this study, we aimed to investigate the association between serum MFAP4 and liver fibrosis severity in NAFLD patients. Methods A case–control study was conducted in which NAFLD patients (n = 25) and healthy participants (n = 12) were recruited. Liver fibrosis/cirrhosis was assessed by transient elastography (TE) and biochemical parameters were collected. Serum MFAP4 was measured by sandwich ELISA based on two monoclonal anti‐MFAP4 antibodies and calibrated with a standard of recombinant MFAP4. Results Serum MFAP4 levels increased with fibrosis severity and were highly upregulated in patients with cirrhosis (F4 fibrosis stage). In addition, serum MFAP4 levels positively correlated with TE measurement and showed significant association with the severely advanced fibrotic stage in NAFLD patients, in multiple linear regression analysis following adjustment for age, gender, and body mass index. Conclusion This study suggests the use of MFAP4 as a potential diagnostic noninvasive biomarker for cirrhosis screening in NAFLD patients. Previous studies validated the applicability and high diagnostic accuracy of serum MFAP4 in detection of HCV and alcoholic liver disease‐related liver fibrosis, whereas the applicability of serum MFAP4 to assess liver fibrosis in NAFLD patients has not been previously investigated. In the present study, we demonstrated for the first time that MFAP4 serum levels are associated with transient elastography measurements and remarkably increase in the severely advanced fibrosis/ cirrhosis (F4) patients when compared to moderate and advanced fibrosis (F1‐F2) and F3 patients, suggesting MFAP4 as a new serum biomarker for cirrhosis screening in NAFLD patients.