慢性肝病中Mac-2结合蛋白糖基化异构体水平与营养状况的关联

Association of Mac-2-binding protein glycosylation isomer level with nutritional status in chronic liver disease.

作者信息

Eso Yuji, Takai Atsushi, Taura Kojiro, Takahashi Ken, Ueda Yoshihide, Marusawa Hiroyuki, Seno Hiroshi

机构信息

Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

J Gastroenterol Hepatol. 2018 Feb 22. doi: 10.1111/jgh.14130.

DOI:10.1111/jgh.14130

PMID:29473206

Abstract

BACKGROUND AND AIM

Mac-2-binding protein glycosylation isomer (M2BPGi) was recently identified as a serum glycobiomarker for liver fibrosis. However, the relationship between M2BPGi and malnutrition in patients with chronic liver disease (CLD) is unknown. We aimed to evaluate whether M2BPGi could be a surrogate marker for malnutrition in patients with CLD.

METHODS

In total, 338 outpatients with CLD were enrolled (median age: 67 years). We evaluated the associations among liver fibrosis markers (M2BPGi, fibrosis-4 index, and aspartate aminotransferase-to-platelet count ratio index), Child-Pugh stages, and nutritional status markers.

RESULTS

The median value (range) of serum M2BPGi levels was 0.94 cut-off index (COI) (0.22-11.57) in chronic hepatitis and Child-Pugh A (n = 274), 4.775 COI (1.32-16.68) in Child-Pugh B (n = 46), and 11.37 COI (6.03-18.33) in Child-Pugh C (n = 18) (overall significance, P < 0.001). Serum M2BPGi levels showed a strong correlation with serum albumin concentration and controlling nutritional status score (r = -0.649, P < 0.001 and r = 0.671, P < 0.001, respectively). The correlations between M2BPGi and nutritional status markers were especially high in patients with hepatitis C virus infection and non-B non-C hepatitis and patients with hepatocellular carcinoma. Among the three fibrosis markers, M2BPGi yielded the highest area under the receiver operating characteristic curve (0.920) for predicting hypoalbuminemia at an optimal cut-off value of 2.41 (sensitivity, 87.3%; specificity, 87.6%; P < 0.001).

CONCLUSIONS

Serum M2BPGi levels are correlated with nutritional status markers in patients with CLD and could be a useful clinical marker of malnutrition.

摘要

背景与目的

Mac-2结合蛋白糖基化异构体（M2BPGi）最近被确定为肝纤维化的血清糖生物标志物。然而，M2BPGi与慢性肝病（CLD）患者营养不良之间的关系尚不清楚。我们旨在评估M2BPGi是否可以作为CLD患者营养不良的替代标志物。

方法

总共纳入了338例CLD门诊患者（中位年龄：67岁）。我们评估了肝纤维化标志物（M2BPGi、纤维化-4指数和天冬氨酸转氨酶与血小板计数比值指数）、Child-Pugh分级和营养状况标志物之间的关联。

结果

慢性肝炎和Child-Pugh A级患者（n = 274）血清M2BPGi水平的中位数（范围）为0.94截断指数（COI）（0.22 - 11.57），Child-Pugh B级患者（n = 46）为4.775 COI（1.32 - 16.68），Child-Pugh C级患者（n = 18）为11.37 COI（6.03 - 18.33）（总体显著性，P < 0.001）。血清M2BPGi水平与血清白蛋白浓度和控制营养状况评分呈强相关（r = -0.649，P < 0.001；r = 0.671，P < 0.001）。在丙型肝炎病毒感染和非B非C型肝炎患者以及肝细胞癌患者中，M2BPGi与营养状况标志物之间的相关性尤其高。在三种纤维化标志物中，M2BPGi在预测低白蛋白血症方面的受试者操作特征曲线下面积最高（0.920），最佳截断值为2.41（敏感性，87.3%；特异性，87.6%；P < 0.001）。