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Cytokeratin-18 and uric acid predicts disease severity in Taiwanese nonalcoholic steatohepatitis patients

BACKGROUND & AIMS: Identification of disease severity remains a challenge in the management of non-alcoholic steatohepatitis (NASH). Cytokeratin-18 (CK18), is a recently developed non-invasive biomarker for NASH. We aimed to assess the performance of CK18 in disease severity prediction among Tai...

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Autores principales: Huang, Jee-Fu, Yeh, Ming-Lun, Huang, Chung-Feng, Huang, Ching-I, Tsai, Pei-Chien, Tai, Chi-Ming, Yang, Hua-Ling, Dai, Chia-Yen, Hsieh, Meng-Hsuan, Chen, Shinn-Chern, Yu, Ming-Lung, Chuang, Wan-Long
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5417412/
https://www.ncbi.nlm.nih.gov/pubmed/28472039
http://dx.doi.org/10.1371/journal.pone.0174394
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author Huang, Jee-Fu
Yeh, Ming-Lun
Huang, Chung-Feng
Huang, Ching-I
Tsai, Pei-Chien
Tai, Chi-Ming
Yang, Hua-Ling
Dai, Chia-Yen
Hsieh, Meng-Hsuan
Chen, Shinn-Chern
Yu, Ming-Lung
Chuang, Wan-Long
author_facet Huang, Jee-Fu
Yeh, Ming-Lun
Huang, Chung-Feng
Huang, Ching-I
Tsai, Pei-Chien
Tai, Chi-Ming
Yang, Hua-Ling
Dai, Chia-Yen
Hsieh, Meng-Hsuan
Chen, Shinn-Chern
Yu, Ming-Lung
Chuang, Wan-Long
author_sort Huang, Jee-Fu
collection PubMed
description BACKGROUND & AIMS: Identification of disease severity remains a challenge in the management of non-alcoholic steatohepatitis (NASH). Cytokeratin-18 (CK18), is a recently developed non-invasive biomarker for NASH. We aimed to assess the performance of CK18 in disease severity prediction among Taiwanese NASH patients. METHODS: A total of 76 biopsy-proven NASH patients (54 males, age = 41.0 ± 13.5 years) were consecutively recruited. The optimal cutoff values of CK18 for each stage of fibrosis were correlated with their histopathological manifestations. RESULTS: There were 23 (30.3%) patients of Metavir fibrosis stage 0 (F0), 32 (42.1%) patients of F1, 14 (18.4%) patients of F2, and 7 (9.2%) patients of F3-4, respectively. The CK18 levels among those patients of F0, F1, F2, F3-4 were 86.7 ± 75.6 U/L, 122.4 ± 123.8 U/L, 160.7 ± 120.4 U/L, and 507.3 ± 343 U/L, respectively (trend for P<0.001). The adjusted optimal cutoff value for F2 prediction was 312.5 U/L, yielding the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the accuracy of 96.4%, 28.6%, 77.9%, 75%, and 77.6%, respectively (P = 0.009). For the prediction of advanced fibrosis (F3-4), the adjusted optimal cutoff value was 374.5 U/L, yielding the sensitivity, specificity, PPV, NPV, and the accuracy of 97.1%, 54.1%, 95.7%, 66.7%, and 77.6%, respectively (P = 0.003). Among those patients without hyperuricemia, the PPV, NPV, and accuracy of CK18 reached 100%, 95.8%, and 96%, respectively (P<0.001). CONCLUSIONS: CK18 combined with uric acid measurement is a promising non-invasive biomarker for prediction of disease severity in NASH patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT01068444.
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spelling pubmed-54174122017-05-14 Cytokeratin-18 and uric acid predicts disease severity in Taiwanese nonalcoholic steatohepatitis patients Huang, Jee-Fu Yeh, Ming-Lun Huang, Chung-Feng Huang, Ching-I Tsai, Pei-Chien Tai, Chi-Ming Yang, Hua-Ling Dai, Chia-Yen Hsieh, Meng-Hsuan Chen, Shinn-Chern Yu, Ming-Lung Chuang, Wan-Long PLoS One Research Article BACKGROUND & AIMS: Identification of disease severity remains a challenge in the management of non-alcoholic steatohepatitis (NASH). Cytokeratin-18 (CK18), is a recently developed non-invasive biomarker for NASH. We aimed to assess the performance of CK18 in disease severity prediction among Taiwanese NASH patients. METHODS: A total of 76 biopsy-proven NASH patients (54 males, age = 41.0 ± 13.5 years) were consecutively recruited. The optimal cutoff values of CK18 for each stage of fibrosis were correlated with their histopathological manifestations. RESULTS: There were 23 (30.3%) patients of Metavir fibrosis stage 0 (F0), 32 (42.1%) patients of F1, 14 (18.4%) patients of F2, and 7 (9.2%) patients of F3-4, respectively. The CK18 levels among those patients of F0, F1, F2, F3-4 were 86.7 ± 75.6 U/L, 122.4 ± 123.8 U/L, 160.7 ± 120.4 U/L, and 507.3 ± 343 U/L, respectively (trend for P<0.001). The adjusted optimal cutoff value for F2 prediction was 312.5 U/L, yielding the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the accuracy of 96.4%, 28.6%, 77.9%, 75%, and 77.6%, respectively (P = 0.009). For the prediction of advanced fibrosis (F3-4), the adjusted optimal cutoff value was 374.5 U/L, yielding the sensitivity, specificity, PPV, NPV, and the accuracy of 97.1%, 54.1%, 95.7%, 66.7%, and 77.6%, respectively (P = 0.003). Among those patients without hyperuricemia, the PPV, NPV, and accuracy of CK18 reached 100%, 95.8%, and 96%, respectively (P<0.001). CONCLUSIONS: CK18 combined with uric acid measurement is a promising non-invasive biomarker for prediction of disease severity in NASH patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT01068444. Public Library of Science 2017-05-04 /pmc/articles/PMC5417412/ /pubmed/28472039 http://dx.doi.org/10.1371/journal.pone.0174394 Text en © 2017 Huang et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Huang, Jee-Fu
Yeh, Ming-Lun
Huang, Chung-Feng
Huang, Ching-I
Tsai, Pei-Chien
Tai, Chi-Ming
Yang, Hua-Ling
Dai, Chia-Yen
Hsieh, Meng-Hsuan
Chen, Shinn-Chern
Yu, Ming-Lung
Chuang, Wan-Long
Cytokeratin-18 and uric acid predicts disease severity in Taiwanese nonalcoholic steatohepatitis patients
title Cytokeratin-18 and uric acid predicts disease severity in Taiwanese nonalcoholic steatohepatitis patients
title_full Cytokeratin-18 and uric acid predicts disease severity in Taiwanese nonalcoholic steatohepatitis patients
title_fullStr Cytokeratin-18 and uric acid predicts disease severity in Taiwanese nonalcoholic steatohepatitis patients
title_full_unstemmed Cytokeratin-18 and uric acid predicts disease severity in Taiwanese nonalcoholic steatohepatitis patients
title_short Cytokeratin-18 and uric acid predicts disease severity in Taiwanese nonalcoholic steatohepatitis patients
title_sort cytokeratin-18 and uric acid predicts disease severity in taiwanese nonalcoholic steatohepatitis patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5417412/
https://www.ncbi.nlm.nih.gov/pubmed/28472039
http://dx.doi.org/10.1371/journal.pone.0174394
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