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A Novel Fibrosis Index Comprising a Non-Cholesterol Sterol Accurately Predicts HCV-Related Liver Cirrhosis

Magdalena Ydreborg ; Vera Lisovskaja (Institutionen för matematiska vetenskaper, matematisk statistik) ; Martin Lagging ; P. B. Christensen ; N. Langeland ; M. R. Buhl ; C. Pedersen ; K. Morch ; Rune Wejstål ; Gunnar Norkrans ; Magnus Lindh ; M. Farkkila ; Johan Westin
Plos One (1932-6203). Vol. 9 (2014), 4, p. artikel nr e93601.
[Artikel, refereegranskad vetenskaplig]

Diagnosis of liver cirrhosis is essential in the management of chronic hepatitis C virus (HCV) infection. Liver biopsy is invasive and thus entails a risk of complications as well as a potential risk of sampling error. Therefore, non-invasive diagnostic tools are preferential. The aim of the present study was to create a model for accurate prediction of liver cirrhosis based on patient characteristics and biomarkers of liver fibrosis, including a panel of non-cholesterol sterols reflecting cholesterol synthesis and absorption and secretion. We evaluated variables with potential predictive significance for liver fibrosis in 278 patients originally included in a multicenter phase III treatment trial for chronic HCV infection. A stepwise multivariate logistic model selection was performed with liver cirrhosis, defined as Ishak fibrosis stage 5-6, as the outcome variable. A new index, referred to as Nordic Liver Index (NoLI) in the paper, was based on the model:Log-odds (predicting cirrhosis) =-12.17+ (agex0.11) + (BMI (kg/m(2))x0.23) + (D-7-lathosterol (mu g/100 mg cholesterol)x(-0.013)) + (Platelet count (x10(9)/L)x(-0.018)) + (Prothrombin-INRx3.69). The area under the ROC curve (AUROC) for prediction of cirrhosis was 0.91 (95% CI 0.86-0.96). The index was validated in a separate cohort of 83 patients and the AUROC for this cohort was similar (0.90; 95% CI: 0.82-0.98). In conclusion, the new index may complement other methods in diagnosing cirrhosis in patients with chronic HCV infection.

Nyckelord: CHRONIC HEPATITIS-C, PRIMARY BILIARY-CIRRHOSIS, STANDARD LABORATORY, TESTS, CHRONIC VIRAL-HEPATITIS, TRANSIENT ELASTOGRAPHY, VIRUS-INFECTION, INSULIN-RESISTANCE, SERUM MARKERS, STEATOSIS, TRANSPLANTATION, ETTINEN TA, 1988, JOURNAL OF LIPID RESEARCH, V29, P43, ETTINEN TA, 1990, AMERICAN JOURNAL OF EPIDEMIOLOGY, V131, P20



Denna post skapades 2014-06-13. Senast ändrad 2016-06-01.
CPL Pubid: 199174

 

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Institutioner (Chalmers)

Institutionen för biomedicin, avdelningen för infektionssjukdomar (GU)
Institutionen för matematiska vetenskaper, matematisk statistik (2005-2016)

Ämnesområden

Infektionsmedicin

Chalmers infrastruktur