Cargando…
Non-invasive biomarkers for identification of vanishing bile duct syndrome among children with acute cholestatic hepatitis
BACKGROUND: The identification of vanishing bile duct syndrome (VBDS) is still challenging before liver biopsy. This study tried to explore non-invasive biomarkers for identification of VBDS among children with acute cholestatic hepatitis. METHODS: Between January 2017 and December 2021, 192 childre...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644022/ https://www.ncbi.nlm.nih.gov/pubmed/37969129 http://dx.doi.org/10.21037/tp-23-305 |
_version_ | 1785147191863541760 |
---|---|
author | Wang, Neng-Li Chen, Lian Lin, Jing Lu, Yi Fang, Wei-Yuan Xie, Xin-Bao Wang, Jian-She |
author_facet | Wang, Neng-Li Chen, Lian Lin, Jing Lu, Yi Fang, Wei-Yuan Xie, Xin-Bao Wang, Jian-She |
author_sort | Wang, Neng-Li |
collection | PubMed |
description | BACKGROUND: The identification of vanishing bile duct syndrome (VBDS) is still challenging before liver biopsy. This study tried to explore non-invasive biomarkers for identification of VBDS among children with acute cholestatic hepatitis. METHODS: Between January 2017 and December 2021, 192 children underwent native-liver biopsy for acute cholestatic hepatitis with onset after 6 months of age. VBDS was diagnosed by liver biopsy. Differences of liver biochemical indices were compared between children with and without VBDS. Diagnostic performances for VBDS were tested by receiver operating characteristic (ROC) curve analyses. RESULTS: Among the 192 patients, 24 (12.5%) were diagnosed with VBDS based on liver biopsy. At biopsy, their levels of total bilirubin (TB), direct bilirubin (DB), γ-glutamyl transpeptidase (GGT), total bile acid, triglyceride, and total cholesterol (TCH) were higher than patients without VBDS (all P<0.05). However, only GGT and TCH could distinguish patients with VBDS from patients without VBDS with an area under ROC curve (AUC) >0.850. Using GGT >446 U/L as a cut-off value, the sensitivity was 87.5%, the specificity was 91.6%, and the AUC was 0.948 (P<0.001). Using TCH >6.4 mmol/L as a cut-off value, the sensitivity was 100.0%, the specificity was 89.8%, and the AUC was 0.983 (P<0.001). A total of 28 patients had both GGT >446 U/L and TCH >6.4 mmol/L, including 21 patients with VBDS and 7 without VBDS (21/28 vs. 3/143, P<0.0001). Three patients with VBDS would be missed for GGT <446 U/L. CONCLUSIONS: Both GGT and TCH can be used as non-invasive biomarkers for identification of VBDS among children with acute cholestatic hepatitis. |
format | Online Article Text |
id | pubmed-10644022 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-106440222023-11-15 Non-invasive biomarkers for identification of vanishing bile duct syndrome among children with acute cholestatic hepatitis Wang, Neng-Li Chen, Lian Lin, Jing Lu, Yi Fang, Wei-Yuan Xie, Xin-Bao Wang, Jian-She Transl Pediatr Original Article BACKGROUND: The identification of vanishing bile duct syndrome (VBDS) is still challenging before liver biopsy. This study tried to explore non-invasive biomarkers for identification of VBDS among children with acute cholestatic hepatitis. METHODS: Between January 2017 and December 2021, 192 children underwent native-liver biopsy for acute cholestatic hepatitis with onset after 6 months of age. VBDS was diagnosed by liver biopsy. Differences of liver biochemical indices were compared between children with and without VBDS. Diagnostic performances for VBDS were tested by receiver operating characteristic (ROC) curve analyses. RESULTS: Among the 192 patients, 24 (12.5%) were diagnosed with VBDS based on liver biopsy. At biopsy, their levels of total bilirubin (TB), direct bilirubin (DB), γ-glutamyl transpeptidase (GGT), total bile acid, triglyceride, and total cholesterol (TCH) were higher than patients without VBDS (all P<0.05). However, only GGT and TCH could distinguish patients with VBDS from patients without VBDS with an area under ROC curve (AUC) >0.850. Using GGT >446 U/L as a cut-off value, the sensitivity was 87.5%, the specificity was 91.6%, and the AUC was 0.948 (P<0.001). Using TCH >6.4 mmol/L as a cut-off value, the sensitivity was 100.0%, the specificity was 89.8%, and the AUC was 0.983 (P<0.001). A total of 28 patients had both GGT >446 U/L and TCH >6.4 mmol/L, including 21 patients with VBDS and 7 without VBDS (21/28 vs. 3/143, P<0.0001). Three patients with VBDS would be missed for GGT <446 U/L. CONCLUSIONS: Both GGT and TCH can be used as non-invasive biomarkers for identification of VBDS among children with acute cholestatic hepatitis. AME Publishing Company 2023-10-27 2023-10-30 /pmc/articles/PMC10644022/ /pubmed/37969129 http://dx.doi.org/10.21037/tp-23-305 Text en 2023 Translational Pediatrics. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Wang, Neng-Li Chen, Lian Lin, Jing Lu, Yi Fang, Wei-Yuan Xie, Xin-Bao Wang, Jian-She Non-invasive biomarkers for identification of vanishing bile duct syndrome among children with acute cholestatic hepatitis |
title | Non-invasive biomarkers for identification of vanishing bile duct syndrome among children with acute cholestatic hepatitis |
title_full | Non-invasive biomarkers for identification of vanishing bile duct syndrome among children with acute cholestatic hepatitis |
title_fullStr | Non-invasive biomarkers for identification of vanishing bile duct syndrome among children with acute cholestatic hepatitis |
title_full_unstemmed | Non-invasive biomarkers for identification of vanishing bile duct syndrome among children with acute cholestatic hepatitis |
title_short | Non-invasive biomarkers for identification of vanishing bile duct syndrome among children with acute cholestatic hepatitis |
title_sort | non-invasive biomarkers for identification of vanishing bile duct syndrome among children with acute cholestatic hepatitis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644022/ https://www.ncbi.nlm.nih.gov/pubmed/37969129 http://dx.doi.org/10.21037/tp-23-305 |
work_keys_str_mv | AT wangnengli noninvasivebiomarkersforidentificationofvanishingbileductsyndromeamongchildrenwithacutecholestatichepatitis AT chenlian noninvasivebiomarkersforidentificationofvanishingbileductsyndromeamongchildrenwithacutecholestatichepatitis AT linjing noninvasivebiomarkersforidentificationofvanishingbileductsyndromeamongchildrenwithacutecholestatichepatitis AT luyi noninvasivebiomarkersforidentificationofvanishingbileductsyndromeamongchildrenwithacutecholestatichepatitis AT fangweiyuan noninvasivebiomarkersforidentificationofvanishingbileductsyndromeamongchildrenwithacutecholestatichepatitis AT xiexinbao noninvasivebiomarkersforidentificationofvanishingbileductsyndromeamongchildrenwithacutecholestatichepatitis AT wangjianshe noninvasivebiomarkersforidentificationofvanishingbileductsyndromeamongchildrenwithacutecholestatichepatitis |