Prediction of Advanced Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease by Type IV Collagen 7S.
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Ishiba Hiroshi, Sumida Yoshio, Kamada Yoshihiro, Fujii Hideki, Iwaki Michihiro, Hayashi Hideki, Toyoda Hidenori, Oeda Satoshi, Hyogo Hideyuki, Kawanaka Miwa, Morishita Asahiro, Munekage Kensuke, Kawata Kazuhito, Tsutsumi Tsubasa, Sawada Koji, Maeshiro Tatsuji, Tobita Hiroshi, Yoshida Yuichi, Naito Masafumi, Araki Asuka, Arakaki Shingo, Kawaguchi Takumi, Noritake Hidenao, Ono Masafumi, Masaki Tsutomu, Yasuda Satoshi, Tomita Eiichi, Yoneda Masato, Tokushige Akihiro, Takahashi Hirokazu, Ueda Shinichiro, Aishima Shinichi, Nakajima Atsushi, Okanoue Takeshi, Japan Study Group of Non-alcoholic Fatty Liver Disease (JSG-NAFLD)
Аннотация
METHODS: Overall, 881 Japanese patients with biopsy-proven nonalcoholic fatty liver disease between 1994 and 2020 were enrolled. Serum COL4-7S levels were measured by radioimmunoassay, and 2 cutoff points were set as 5.1 ng/mL and 7.2 ng/mL. The patients were assigned to 3 groups based on the COL4-7S level. Cox regression analysis was used to estimate the predictive performance of COL4-7S for liver-related events (LREs).
RESULTS: Overall, 866 MASLD patients were enrolled. The median follow-up period was 4.3 years. Thirty-one patients developed LREs. The area under the curve for COL4-7S in patients with AF was 0.847. The adjusted hazard ratios for LREs in 4.8 ≤ COL4-7S < 6.8 and COL4-7S ≥6.8 patients were 6.0 (P = .009) and 27.9 (P < .001) compared with COL4-7S <4.8, and the adjusted hazard ratio of AF on liver biopsy was 1.6 (P = .286). The incidence rate of LREs was low when the Fibrosis-4 Index (FIB-4) <1.30. When the FIB-4 >1.30, effective stratification of the LRE risk group was possible by stratification of COL4-7S. A combination of FIB-4 and COL4-7S stratified risk groups for future LRE development more effectively than when used singly.
CONCLUSION: COL4-7S accurately diagnosed AF and predicted LREs. COL4-7S and a combination of FIB-4 and COL4-7S might help physicians estimate the prognosis of future LRE risk.