Clinica chimica acta; international journal of clinical chemistry · 2026
Circulating suPAR as a noninvasive biomarker of fibrosis and immune activation in autoimmune liver diseases.
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Zhan Fuguo, Chen Tianbin, Liang Jun, Liu Can, Huang Mingdong, Jiang Longguang
Аннотация
AIM: Noninvasive assessment of fibrosis in autoimmune liver diseases (AILDs) remains challenging. Soluble urokinase plasminogen activator receptor (suPAR) is a marker of systemic immune activation, but its role in AILDs is unclear. This study aimed to evaluate the diagnostic performance of circulating suPAR in AILDs and its association with fibrosis severity and immune activation.
METHODS: A retrospective study included 117 patients with AILDs (n = 61), chronic hepatitis B (CHB, n = 33), metabolic dysfunction-associated steatotic liver disease (MASLD, n = 23), and 44 healthy controls. Serum suPAR was measured by chemiluminescent immunoassay. Correlations with fibrosis indices (APRI, FIB-4), liver stiffness measurement (LSM), and IgG were assessed. ROC analysis evaluated diagnostic accuracy.
RESULTS: Serum suPAR was significantly higher in AILDs than in controls, CHB, and MASLD (median 5.16 vs. 3.58, 3.92, and 3.13 ng/mL; all P < 0.001). suPAR correlated strongly with APRI (r = 0.66), FIB-4 (r = 0.65), and LSM (r = 0.62), and modestly with IgG (r = 0.31). ROC analysis demonstrated robust discrimination between AILDs and controls (AUC = 0.839), CHB (AUC = 0.724), and MASLD (AUC = 0.944). Patients with higher suPAR levels exhibited more advanced fibrosis and greater biochemical evidence of liver injury.
CONCLUSIONS: Circulating suPAR is elevated in AILDs, reflecting fibrosis and immune activation. suPAR provides complementary, antibody-independent diagnostic value and may serve as a noninvasive biomarker for differentiating AILDs from CHB and MASLD in clinical practice.
METHODS: A retrospective study included 117 patients with AILDs (n = 61), chronic hepatitis B (CHB, n = 33), metabolic dysfunction-associated steatotic liver disease (MASLD, n = 23), and 44 healthy controls. Serum suPAR was measured by chemiluminescent immunoassay. Correlations with fibrosis indices (APRI, FIB-4), liver stiffness measurement (LSM), and IgG were assessed. ROC analysis evaluated diagnostic accuracy.
RESULTS: Serum suPAR was significantly higher in AILDs than in controls, CHB, and MASLD (median 5.16 vs. 3.58, 3.92, and 3.13 ng/mL; all P < 0.001). suPAR correlated strongly with APRI (r = 0.66), FIB-4 (r = 0.65), and LSM (r = 0.62), and modestly with IgG (r = 0.31). ROC analysis demonstrated robust discrimination between AILDs and controls (AUC = 0.839), CHB (AUC = 0.724), and MASLD (AUC = 0.944). Patients with higher suPAR levels exhibited more advanced fibrosis and greater biochemical evidence of liver injury.
CONCLUSIONS: Circulating suPAR is elevated in AILDs, reflecting fibrosis and immune activation. suPAR provides complementary, antibody-independent diagnostic value and may serve as a noninvasive biomarker for differentiating AILDs from CHB and MASLD in clinical practice.