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Open Access 01-12-2017 | Research article

Angiopoietin-like protein as a novel marker for liver fibrosis in chronic hepatitis B patients with normal to minimally raised ALT

Authors: Yongqiong Deng, Hong Zhao, Jiyuan Zhou, Linlin Yan, Guiqiang Wang, China HepB-Related Fibrosis Assessment Research Group

Published in: BMC Infectious Diseases | Issue 1/2017

Abstract

Background

For hepatitis B patients who do not meet the treatment criteria recommended by guidelines, therapy decisions depend on hepatic histology. Angiopoietin-like protein 2 (Angptl2) is a mediator of chronic inflammation that contributes to extracellular matrix remodeling. The aim of this study was to explore the predictive value of Angptl2 as a novel biomarker of liver histology.

Methods

Hepatitis B patients with normal to minimally raised ALT were recruited. Serum Angptl2 concentrations were detected using commercial ELISA kit. The fibrosis score were assessed according to Ishak criteria. Significant fibrosis was defined as ISHAK score ≥ 3.

Results

Of 460 patients, 223 cases served as training cohort and 237 ones as validation cohort. Serum Angptl2 concentration was significantly associated with fibrosis scores in both training and validation group. Angptl2 combined index (ACI) for assessing significant fibrosis was developed from training cohort, based on Angptl2 and conventional variables. ACI showed areas under receiver-operating characteristic curve (AUC) of 0.835 for predicting significant fibrosis, which was superior to APRI (AUC = 0.776, P = 0.049), FIB-4 (AUC = 0.750, P = 0.010), Hui model (AUC = 0.756, P = 0.028), and had a better trend than Forn’s index (AUC = 0.796, P = 0.083) in training cohort. Finally, validation cohort revealed its robustness and reliability.

Conclusion

Higher Angptl2 level represents as a potential biomarker independently associated with fibrosis stages. Compared with APRI, Hui model, FIB-4, Forn’s index, ACI did better in diagnosing significant fibrosis in hepatitis B patients.

Trial registration

The complete clinical trials protocol is available by request at clinicaltrials.gov (NCT01962155) and chictr.org (ChiCTR-DDT-13003724).

Available only for authorised users

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Title: Angiopoietin-like protein as a novel marker for liver fibrosis in chronic hepatitis B patients with normal to minimally raised ALT
Authors: Yongqiong Deng
Hong Zhao
Jiyuan Zhou
Linlin Yan
Guiqiang Wang
China HepB-Related Fibrosis Assessment Research Group
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Infectious Diseases / Issue 1/2017
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-017-2728-7

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Abstract

Background

Methods

Results

Conclusion

Trial registration

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