Serum WFA + -Mac-2 binding protein more reliably distinguishes liver fibrosis stages in non-alcoholic fatty liver disease than serum Mac-2 binding protein

• Published in: Hepatology research
• Main Authors: Atsukawa, Masanori, Tsubota, Akihito, Okubo, Tomomi, Arai, Taeang, Nakagawa, Ai, Itokawa, Norio, Kondo, Chisa, Kato, Keizo, Hatori, Tsutomu, Hano, Hiroshi, Oikawa, Tsunekazu, Emoto, Naoya, Abe, Masanori, Kage, Masayoshi, Iwakiri, Katsuhiko
• Format: Journal Article
• Language: English
• Published: Netherlands 23.12.2017
• Subjects: WFA+-Mac-2BP; non-alcoholic fatty liver disease; fibrosis; Mac-2BP; liver cirrhosis
• ISSN: 1386-6346

Serum Mac-2 binding protein (M2BP) and Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA -M2BP) are used to estimate the liver fibrosis stage in chronic liver diseases. However, few head-to-head study has been conducted to compare the two biomarkers in non-alcoholic fatty liver disease (NAFLD). Serum M2BP and WFA -M2BP levels were compared against clinical characteristics and liver histological manifestations in the same samples collected from 213 biopsy-proven NAFLD patients. Median levels (range) of M2BP and WFA -M2BP were 1.58 (0.70-7.75) pg/mL and 0.85 (0.22-11.32) cutoff index (COI), respectively. Fibrosis stages 1, 2, 3, and 4 were determined in 136, 37, 17, and 23 patients, respectively. Median levels of both biomarkers increased stepwise with fibrosis progression. M2BP and WFA -M2BP levels showed a significant positive correlation (r=0.643, P=2.91×10 ), but a marked discrepancy between both biomarkers was noted in five stage-4 and three stage-1 patients, who had high WFA -M2BP but relatively low M2BP levels. Most of these outliers had findings suggestive of more advanced fibrosis. For diagnosing any fibrosis severity, WFA -M2BP had greater AUC and predictive accuracy than M2BP. Among eight fibrosis markers/indices, WFA -M2BP yielded the second highest AUC (0.832) and the highest predictive accuracy (82.2%) to diagnose cirrhosis. WFA -M2BP showed the second highest predictive accuracy to diagnose severe fibrosis (78.4%) and significant fibrosis (76.1%). This head-to-head comparison suggests that WFA -M2BP is superior to M2BP for distinguishing liver fibrosis stages in NAFLD patients. A marked discrepancy between the two biomarkers may be indicative of advanced NAFLD (UMIN000023286).