Serum Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) Can Predict Mild or Significant Liver Fibrosis in Non-alcoholic Fatty Liver Disease

Abstract

Background: The serum levels of M2BPGi increase with liver fibrosis progression in patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. However, the diagnostic performance of M2BPGi in non-alcoholic fatty liver disease (NAFLD) patients remains unclear. Objectives: To assess the severity of liver fibrosis in NAFLD patients and healthy controls by M2BPGi using acoustic radiation force impulse (ARFI) as the standard reference. Methods: Those suffering from NAFLD and healthy controls were recruited. NAFLD diagnosis was confirmed using fatty liver in imaging after excluding HCV, HBV, alcohol, drug, or other known causes of chronic liver disease. ARFI was used as the standard reference to determine the stage of liver fibrosis. Results: A total of 226 subjects were recruited, including 130 (57.5%) NAFLD patients who were divided into three groups according to the stage of liver fibrosis: F0, F1, and F ≥ 2. The serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST to platelet ratio index (APRI), M2BPGi, and the fatty liver grade were significantly different between the three groups. The levels of M2BPGi were correlated with median ARFI value (P < 0.001), APRI (P = 0.011), and fibrosis 4 index (FIB-4) (P < 0.001). The area under the curve (AUC) of M2BPGi test was 0.58 for F ≥ 1 and 0.68 for F ≥ 2, respectively (P = 0.039 and P = 0.024). Conclusions: The M2BPGi levels were correlated with ARFI, APRI, and FIB-4 scores in this study population. The level of M2BPGi could predict mild (F ≥ 1) and significant liver fibrosis (F ≥ 2) in NAFLD patients, suggesting a surrogate marker to differentiate between normal, mild, and significant fibrosis.

Evaluation of Mac-2 binding protein glycosylation isomer (M2BPGi) as a diagnostic marker for staging liver fibrosis: a meta-analysis

“…However, 2 of the 26 trials were further excluded, one for wrong sample size and another for unavailable full text after contacting its authors. Ultimately, 24 trials were included in this study ( Nah et al, 2020 ; Ueda et al, 2020 ; Mak et al, 2019 ; Hur et al, 2022 ; Jang et al, 2021 ; Xu et al, 2017 ; Matsuura et al, 2018 ; Ueno et al, 2018 ; Tsuji et al, 2020 ; Jekarl et al, 2018 ; Fujinaga et al, 2021 ; Wei et al, 2018 ; Mak et al, 2022 ; Kim et al, 2020 ; Noguchi et al, 2017 ; Cheng & Wang, 2021 ; Sasaki et al, 2021 ; Yamada et al, 2017 , 2019 ; Jang et al, 2022 ; Moon et al, 2018 ; Umetsu et al, 2018 ; Kimura et al, 2021 ; Numao et al, 2021 ). The specific search strategy is presented in Fig.…”

“…Liver biopsy remains the reference standard for the assessment of hepatic fibrosis, but it is invasive, difficult for repeated evaluation, and highly likely to have sampling error. On top of this, this procedure cannot be applied frequently and is unacceptable for most patients ( Cheng & Wang, 2021 ; Sasaki et al, 2021 ; Noguchi et al, 2017 ). M2BPGi, an isoform of the glycan structure of Mac-2 binding protein (M2BP), has been recently identified as a novel serum marker for liver fibrosis ( Nah et al, 2020 ).…”