A Novel Fibrosis Index Comprising a Non-Cholesterol Sterol Accurately Predicts HCV-Related Liver Cirrhosis
Journal article, 2014
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.
TRANSPLANTATION
V29
INSULIN-RESISTANCE
1990
ETTINEN TA
P20
SERUM MARKERS
STANDARD LABORATORY
STEATOSIS
PRIMARY BILIARY-CIRRHOSIS
TESTS
V131
1988
P43
JOURNAL OF LIPID RESEARCH
VIRUS-INFECTION
AMERICAN JOURNAL OF EPIDEMIOLOGY
ETTINEN TA
CHRONIC HEPATITIS-C
CHRONIC VIRAL-HEPATITIS
TRANSIENT ELASTOGRAPHY
Author
Magdalena Ydreborg
University of Gothenburg
Vera Lisovskaja
University of Gothenburg
Chalmers, Mathematical Sciences, Mathematical Statistics
Martin Lagging
University of Gothenburg
Peer B Christensen
Odense Universitetshospital
Nina Langeland
Universitetet i Bergen
Mads Rauning Buhl
Aarhus Universitet
Court Pedersen
Odense Universitetshospital
Kristine Mørch
Universitetet i Bergen
Rune Wejstål
University of Gothenburg
Gunnar Norkrans
University of Gothenburg
Magnus Lindh
University of Gothenburg
Martti Färkkilä
Helsingin Yliopisto
Johan Westin
University of Gothenburg
PLoS ONE
1932-6203 (ISSN)
Vol. 9 4 artikel nr e93601- e93601Subject Categories (SSIF 2011)
Infectious Medicine
DOI
10.1371/journal.pone.0093601