A Composite Blood Biomarker Including AKR1B10 and Cytokeratin 18 for Progressive Types of Nonalcoholic Fatty Liver Disease

• Published in: Diabetes & metabolism journal Vol. 48; no. 4; pp. 740 - 751
• Main Authors: Choi, Seung Joon, Yoon, Sungjin, Kim, Kyoung-Kon, Kim, Doojin, Lee, Hye Eun, Kim, Kwang Gi, Shin, Seung Kak, Park, Ie Byung, Kim, Seong Min, Lee, Dae Ho
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Diabetes Association / Daehan Dangnyobyeong Hakoe 01.07.2024; Korean Diabetes Association; 대한당뇨병학회
• Subjects: Adult; Aged; akr1b10 protein, human; Alanine Transaminase - blood; Alcohol; Aldehyde Reductase - blood; Aldo-Keto Reductases - blood; Aspartate Aminotransferases - blood; Biomarkers; Biomarkers - blood; Biopsy; Case-Control Studies; Clinical trials; Cytokeratin; Disease Progression; Fatty liver; Female; Gastrointestinal surgery; Humans; keratin-18; Keratin-18 - blood; Liver - diagnostic imaging; Liver - pathology; Liver cancer; Liver cirrhosis; Liver Cirrhosis - blood; Liver Cirrhosis - diagnosis; Liver Cirrhosis - diagnostic imaging; Liver diseases; Liver transplants; Magnetic resonance imaging; Male; Middle Aged; non-alcoholic fatty liver disease; Non-alcoholic Fatty Liver Disease - blood; Original; Proteins; ROC Curve; Variance analysis; Weight control; 내과학; Biomarkers; Magnetic resonance imaging; Non-alcoholic fatty liver disease; Keratin-18; AKR1B10 protein, human
• ISSN: 2233-6079; 2233-6087; 2233-6087
• DOI: 10.4093/dmj.2023.0189

Background: We aimed to evaluate whether composite blood biomarkers including aldo-keto reductase family 1 member B10 (AKR1B10) and cytokeratin 18 (CK-18; a nonalcoholic steatohepatitis [NASH] marker) have clinically applicable performance for the diagnosis of NASH, advanced liver fibrosis, and high-risk NASH (NASH+significant fibrosis).Methods: A total of 116 subjects including healthy control subjects and patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) were analyzed to assess composite blood-based and imaging-based biomarkers either singly or in combination.Results: A composite blood biomarker comprised of AKR1B10, CK-18, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) showed excellent performance for the diagnosis of, NASH, advanced fibrosis, and high-risk NASH, with area under the receiver operating characteristic curve values of 0.934 (95% confidence interval [CI], 0.888 to 0.981), 0.902 (95% CI, 0.832 to 0.971), and 0.918 (95% CI, 0.862 to 0.974), respectively. However, the performance of this blood composite biomarker was inferior to that various magnetic resonance (MR)-based composite biomarkers, such as proton density fat fraction/MR elastography- liver stiffness measurement (MRE-LSM)/ALT/AST for NASH, MRE-LSM+fibrosis-4 index for advanced fibrosis, and the known MR imaging-AST (MAST) score for high-risk NASH.Conclusion: Our blood composite biomarker can be useful to distinguish progressive forms of NAFLD as an initial noninvasive test when MR-based tools are not available.