Serum laminin, type IV collagen and hyaluronan as fibrosis markers in non-alcoholic fatty liver disease

Abstract

Hepatic fibrosis in patients with non-alcoholic fatty liver disease is associated with progression of the disease. In the present study, we analyzed the discriminative ability of serum laminin, type IV collagen and hyaluronan levels to predict the presence of fibrosis in these patients. In this preliminary report, we studied 30 overweight patients divided into two groups according to the absence (group I, N = 19) or presence (group II, N = 11) of fibrosis in a liver biopsy. Triglycerides, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltranspeptidade, hyaluronan (noncompetitive fluoroassay), type IV collagen, and laminin (ELISA) were determined. Group II presented significantly higher mean laminin, hyaluronan, type IV collagen, and aspartate aminotransferase values, which were due to the correlation between these parameters and the stage of fibrosis in the biopsy (Spearman's correlation coefficient, rS = 0.65, 0.62, 0.53, and 0.49, respectively). Analysis of the ROC curve showed that laminin values >282 ng/ml were those with the best diagnostic performance, with 87% accuracy. Association of laminin with type IV collagen showed improvement in the positive predictive value (100%), but with reduction in diagnostic sensitivity (64%). When compared with the criteria of Ratziu et al. [Gastroenterology (2000) 118: 1117-1123] for the diagnosis of septal fibrosis, laminin values presented a better diagnostic accuracy (83 vs 70%). Determination of extracellular matrix components in serum, especially of laminin, may identify patients with non-alcoholic fatty liver disease and fibrosis and these components may be used as indicators for liver biopsy in these patients

Serum hyaluronan and collagen IV as non-invasive markers of liver fibrosis in patients from an endemic area for schistosomiasis mansoni: a field-based study in Brazil

“…Serum C-IV has been used to diagnose liver fibrosis in diseases that evolved with sinusoid capilarisation (Hiramatsu et al 1995, Murawaki et al 2001, pereira et al 2004, Santos et al 2005, Halfon et al 2006, Yoneda et al 2007). Comparing serum C-IV levels between groups, according to the clinical classification of patients with mansonic and hematobic schistosomiasis, Shahin et al (1992) found high serum levels in patients with hepatosplenic schistosomiasis.…”

Relationship between serum transforming growth factor ß1 and liver collagen content in rats treated with carbon tetrachloride

“…A similar study was conducted with serum laminin in the CCl 4 fibrosis model. Although a correlation between increased laminin and the degree of fibrosis has been observed, only cirrhotic animals showed values statistically higher than controls (16) . Taken together, these results suggest that biomarkers are useful for the diagnosis or the exclusion of cirrhosis in animal models but that caution must be taken in order to interpret these results and correlate them with histological findings.…”

Ultrasound versus biological markers in the evaluation of periportal fibrosis in human Schistosoma mansoni

“…Several studies have examined HA serum levels in a number of chronic liver diseases and have suggested that it may be a good marker for detecting fibrosis in cirrhosis, chronic hepatitis B and C and alcoholic and nonalcoholic fatty liver disease (Guéchot et al 1995, Parés et al 1996, Wong et al 1998, Pontinha et al 1999, Santos et al 2005. Ricard-Blum et al (1999), while studying patients with intestinal and HS schistosomiasis and with mild to advanced fibrosis, found higher levels of HA in more advanced forms of schistosomiasis, thereby suggesting a correlation with disease severity.…”