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Association of Serum Chitinase-3-Like Protein 1 with Liver Fibrosis Severity in Autoimmune Liver Diseases.
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Zhang Yazhen, Bao Jianfeng, Yu Wenyan, Zuo Zhongbao, Pan Kenv, Xu Aifang, Wang Miaochan, Xia Lei
Аннотация
BACKGROUND: Autoimmune liver diseases (AILDs) require precise fibrosis staging, but current non-invasive tools are limited. This study aimed to evaluate the diagnostic performance of serum chitinase-3-like protein 1 (CHI3L1) for liver fibrosis in AILDs.
METHODS: This retrospective cohort study consecutively enrolled 226 AILDs patients (including those with autoimmune hepatitis, primary biliary cholangitis, and overlap syndrome) and 40 healthy controls. Cohort 1 (n=112) underwent liver biopsy (Scheuer staging). Cohort 2 (n=114) underwent liver stiffness measurement (LSM) by transient elastography, with no overlap between cohorts. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis and compared with aspartate aminotransferase-to-platelet ratio index (APRI) and the fibrosis-4 index (FIB-4). Multivariable binary logistic regression adjusted for histological inflammation identified independent predictors of advanced fibrosis.
RESULTS: Serum CHI3L1 levels increased significantly with advancing histological (S0-1: 50.6 ng/mL; S2: 80.8 ng/mL; S3-4: 156.3 ng/mL; P < 0.001) and LSM-based fibrosis stages (F0-1: 57.8 ng/mL; F2: 70.9 ng/mL; F3-4: 164.5 ng/mL; P < 0.001). CHI3L1 was significantly correlated with APRI (r = 0.451), FIB-4 (r = 0.511), and LSM (r = 0.671). For diagnosing significant fibrosis (S≥2) and advanced fibrosis (S≥3), CHI3L1 showed areas under the ROC curve (AUC) of 0.833 and 0.851, respectively, performing comparably to FIB-4 and better than APRI. In the LSM cohort, CHI3L1 maintained high diagnostic accuracy (AUC: 0.828 for F≥2, 0.835 for F≥3). Multivariate analysis confirmed serum CHI3L1 is independently associated with advanced liver fibrosis.
CONCLUSION: CHI3L1 level is independently associated with advanced liver fibrosis and shows good diagnostic performance for both significant and advanced liver fibrosis. It is a valuable non-invasive biomarker to supplement existing fibrosis assessment strategies, pending validation across individual AILDs subtypes.
METHODS: This retrospective cohort study consecutively enrolled 226 AILDs patients (including those with autoimmune hepatitis, primary biliary cholangitis, and overlap syndrome) and 40 healthy controls. Cohort 1 (n=112) underwent liver biopsy (Scheuer staging). Cohort 2 (n=114) underwent liver stiffness measurement (LSM) by transient elastography, with no overlap between cohorts. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis and compared with aspartate aminotransferase-to-platelet ratio index (APRI) and the fibrosis-4 index (FIB-4). Multivariable binary logistic regression adjusted for histological inflammation identified independent predictors of advanced fibrosis.
RESULTS: Serum CHI3L1 levels increased significantly with advancing histological (S0-1: 50.6 ng/mL; S2: 80.8 ng/mL; S3-4: 156.3 ng/mL; P < 0.001) and LSM-based fibrosis stages (F0-1: 57.8 ng/mL; F2: 70.9 ng/mL; F3-4: 164.5 ng/mL; P < 0.001). CHI3L1 was significantly correlated with APRI (r = 0.451), FIB-4 (r = 0.511), and LSM (r = 0.671). For diagnosing significant fibrosis (S≥2) and advanced fibrosis (S≥3), CHI3L1 showed areas under the ROC curve (AUC) of 0.833 and 0.851, respectively, performing comparably to FIB-4 and better than APRI. In the LSM cohort, CHI3L1 maintained high diagnostic accuracy (AUC: 0.828 for F≥2, 0.835 for F≥3). Multivariate analysis confirmed serum CHI3L1 is independently associated with advanced liver fibrosis.
CONCLUSION: CHI3L1 level is independently associated with advanced liver fibrosis and shows good diagnostic performance for both significant and advanced liver fibrosis. It is a valuable non-invasive biomarker to supplement existing fibrosis assessment strategies, pending validation across individual AILDs subtypes.