Mater Research, The University of Queensland, Brisbane, Australia.
Centre for Liver Disease Research, The University of Queensland, Brisbane, Australia.
Sci Rep. 2021 Feb 3;11(1):2858. doi: 10.1038/s41598-021-82315-z.
Non-alcoholic fatty liver disease (NAFLD) affects 25% of the adult population globally. Since liver fibrosis is the most important predictor of liver-related complications in patients with NAFLD, identification of patients with advanced fibrosis among at-risk individuals is an important issue in clinical practice. Transient elastography is the best evaluated non-invasive method used in referral centres to assess liver fibrosis, however serum-based tests, such as the Enhanced Liver Fibrosis (ELF) score, have a practical advantage as first-line tests due to their wider availability and lower cost. We previously identified matrix metalloproteinase 7 (MMP7) as a serum biomarker of histological advanced fibrosis in a mixed-etiology patient cohort. In this study we aimed to determine the association between MMP7 and fibrosis, assessed by transient elastography, in patients with NAFLD. Serum MMP7 levels were measured in a cohort of 228 patients with NAFLD. Associations between MMP7, liver stiffness measurement (LSM), ELF score and clinical parameters were determined using logistic regression modelling. Serum MMP7 was associated with clinically significant fibrosis (LSM ≥ 8.2), independent of age, gender, BMI and diabetes. The addition of MMP7 significantly improved the diagnostic performance of the ELF test, particularly in patients over the age of 60. Combinations of serum biomarkers have the potential to improve the sensitivity and specificity of detection of advanced fibrosis in at-risk patients with NAFLD. We have demonstrated that serum MMP7 is independently associated with clinically significant fibrosis and improves the diagnostic performance of currently available tests in older patients.
非酒精性脂肪性肝病（NAFLD）影响着全球 25%的成年人。由于肝纤维化是 NAFLD 患者发生肝脏相关并发症的最重要预测因素，因此识别高危人群中的肝纤维化进展患者是临床实践中的一个重要问题。瞬时弹性成像（TE）是评估肝纤维化的最佳评估方法，用于转诊中心，但血清学检测（如增强肝脏纤维化评分，ELF 评分）作为一线检测具有实用优势，因为其更广泛的可用性和更低的成本。我们之前发现基质金属蛋白酶 7（MMP7）是混合病因患者队列中组织学肝纤维化的血清生物标志物。在这项研究中，我们旨在确定 MMP7 与 NAFLD 患者通过瞬时弹性成像评估的纤维化之间的关系。我们在 228 名 NAFLD 患者的队列中测量了血清 MMP7 水平。使用逻辑回归模型确定 MMP7 与肝硬度测量（LSM）、ELF 评分和临床参数之间的关系。血清 MMP7 与临床显著纤维化（LSM≥8.2）相关，独立于年龄、性别、BMI 和糖尿病。MMP7 的加入显著改善了 ELF 试验的诊断性能，尤其是在 60 岁以上的患者中。血清生物标志物的组合具有提高高危 NAFLD 患者检测进展性纤维化的敏感性和特异性的潜力。我们已经证明，血清 MMP7 与临床显著纤维化独立相关，并提高了老年患者现有检测方法的诊断性能。
