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Open Access 01-12-2017 | Research

Correlation of cell-free DNA plasma concentration with severity of non-alcoholic fatty liver disease

Authors: Thomas Karlas, Lara Weise, Stephanie Kuhn, Felix Krenzien, Matthias Mehdorn, David Petroff, Nicolas Linder, Alexander Schaudinn, Harald Busse, Volker Keim, Johann Pratschke, Johannes Wiegand, Katrin Splith, Moritz Schmelzle

Published in: Journal of Translational Medicine | Issue 1/2017

Abstract

Background

The assessment of fibrosis and inflammatory activity is essential to identify patients with non-alcoholic fatty liver disease (NAFLD) at risk for progressive disease. Serum markers and ultrasound-based methods can replace liver biopsy for fibrosis staging, whereas non-invasive characterization of inflammatory activity remains a clinical challenge. Cell-free DNA (cfDNA) is a novel non-invasive biomarker for assessing cellular inflammation and cell death, which has not been evaluated in NAFLD.

Methods

Patients and healthy controls from two previous studies were included. NAFLD disease activity and severity were non-invasively characterized by liver stiffness measurement (transient elastography, TE) including steatosis assessment with controlled attenuation parameter (CAP), single-proton magnetic resonance spectroscopy (¹H-MRS) for determination of hepatic fat fraction, aminotransferases and serum ferritin. cfDNA levels (90 and 222 bp fragments) were analyzed using quantitative real-time PCR.

Results

Fifty-eight NAFLD patients (age 62 ± 11 years, BMI 28.2 ± 3.5 kg/m²) and 13 healthy controls (age 38 ± 12 years, BMI 22.4 ± 2.1 kg/m²) were included. 90 bp cfDNA levels were significantly higher in NAFLD patients compared to healthy controls: 3.7 (1.3–23.1) vs. 2.9 (1.4–4.1) ng/mL (p = 0.014). In the NAFLD cohort, circulating cfDNA correlated significantly with disease activity and severity, especially in patients with elevated liver stiffness (n = 13, 22%) compared to cases with TE values ≤7 kPa: cf90 bp 6.05 (2.41–23.13) vs. 3.16 (1.29–7.31) ng/mL (p < 0.001), and cf222 bp 14.41 (9.27–22.90) vs. 11.32 (6.05–18.28) ng/mL (p = 0.0041).

Conclusions

Cell-free DNA plasma concentration correlates with established non-invasive markers of NAFLD activity and severity. Therefore, cfDNA should be further evaluated as biomarker for identifying patients at risk for progressive NAFLD.

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Title: Correlation of cell-free DNA plasma concentration with severity of non-alcoholic fatty liver disease
Authors: Thomas Karlas
Lara Weise
Stephanie Kuhn
Felix Krenzien
Matthias Mehdorn
David Petroff
Nicolas Linder
Alexander Schaudinn
Harald Busse
Volker Keim
Johann Pratschke
Johannes Wiegand
Katrin Splith
Moritz Schmelzle
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Journal of Translational Medicine / Issue 1/2017
Electronic ISSN: 1479-5876
DOI: https://doi.org/10.1186/s12967-017-1208-6

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Correlation of cell-free DNA plasma concentration with severity of non-alcoholic fatty liver disease

Abstract

Background

Methods

Results

Conclusions

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