The Association of N-Glycan and Alpha Fetal Protein in Hepatitis B Associated Hepatic Disease

Abstract

Objective: Chronic hepatic disease caused by hepatitis B virus (HBV) is a serious threat to health in worldwide. There is evidence that the change of N-glycan is involved in the mechanism of hepatic fibrosis, liver cirrhosis (LC) and hepatocellular carcinoma (HCC) in patients with hepatitis B. The level of serum alpha-fetoprotein (AFP) is elevated in many patients with hepatitis B infection. AFP is not only a fetal carrier protein and tumor marker, but also participates in the regulation of a variety of important cellular functions, such as cell growth, differentiation, apoptosis, angiogenesis and immune regulation. However, the mechanism between AFP and N-glycan is not clear. The study investigated the association of N-glycan and AFP in Hepatitis B associated hepatic disease.Patients and Methods: Sixty patients with Hepatitis B associated hepatic diseases and twenty healthy individuals were selected in this study. Serum AFP, N-glycan, hematological parameters, and clinical data were assessed in this cohort. The Spearman rank method was used to evaluate the associations among them. The study was designed as a retrospective cross-sectional study. Results：Serum levels of N-glycan and AFP were significantly higher in Patients with hepatic disease compared with the controls; levels of both were elevated with development of the disease. In patients with hepatic disease, N-glycan was positively correlated with AFP, Age, AST, GGT, PT, CA125, while negatively correlated with ALB, CHE, RBC (P < 0.05 for all). AFP was positively correlated with HBV DNA, TBIL, DBIL, AST, ALT, ALP, GGT (P < 0.05 for all), while negatively correlated with ALB and CHE in hepatic disease patients (P < 0.05 for both). In addition, there was a trend of increasing N-glycan with elevated AFP level in the combined hepatic disease group. In LC, the level of N-glycan in the decompensatory was significant higher than in the control (P = 0.007), and AFP level in the compensatory increased than the controls (P = 0.003). In HCC, levels of both N-glycan and AFP in the compensatory and decompensatory groups elevated than those in the control (P < 0.001 and P = 0.004 for N-glycan and P < 0.001 for both in AFP, respectively).Conclusion: Our data suggest that high AFP levels in Hepatitis B related hepatic disease are closely related to the development of liver disease through interaction with N-glycan.