The value of osteopontin in predicting fibrosis in patients with chronic viral hepatitis C

A.G. Sheiko, K.V. Yurko
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Abstract

Background. Diagnosis of an asymptomatic course of chronic viral hepatitis C (HCV) and the existing development of the fibrotic process by determining the marker capabilities of biochemical blood parameters (primarily osteopontin — OP) is an urgent issue in modern medicine. Purpose: to evaluate the prognostic value of biochemical blood markers for diagnosing an asymptoma­tic course of HCV and the existing fibrotic process. Materials and me­thods. Seventy-eight people were examined: 47 from the main group — 19 (40.4 %) women and 28 (59.6 %) men with chronic HCV, and 31 controls — 17 (54.8 %) women and 14 (45.2 %) men without chronic HCV. The median, as well as 25.0% and 75.0% quartiles and relative values were calculated for quantitative and qualitative measures, respectively. Predictors were determined using logistic regression analysis. Results. The data obtained by a univariate analysis indicate a significantly increased risk of develo­ping liver fibrosis on the background of chronic HCV, with alanine aminotransferase (ALT) levels increased by 1.037 times, aspartate aminotransferase (AST) by 1.051 times, gamma-glutamyl transferase (GGT) by 1.017 times; thymol turbidity test by 1.424 times; total protein by 1.162 times and OP by 3.002 times. With increased levels of triglycerides and very low-density lipoproteins, a significant decrease in these risks was found, by 74.7 and 94.7 %, respectively. A multivariate analysis found significantly increased risks of deve­loping liver fibrosis on the background of chronic HCV, with higher levels of AST, total protein, and OP (by 1.028, 1.195 and 2.510 times, respectively). Conclusions. With a significant liver damage by a fibrotic process (stage 3–4), as compared to stage 0–2, there is a probable predominance of biochemical liver markers in the blood of patients with HCV: ALT, AST, GGT, total protein and OP. AST, total protein, and OP were identified as reliable predictors of liver fibrosis. The developed mathematical model has high sensitivity and specificity: 87.5 and 83.9 %, respectively.
骨桥蛋白在预测慢性病毒性丙型肝炎纤维化中的价值
背景。通过测定血液生化指标(主要是骨桥蛋白- OP)的标记能力来诊断慢性丙型肝炎(HCV)的无症状病程和纤维化过程的现有发展是现代医学迫切需要解决的问题。目的:评价血液生化指标在诊断无症状病程及已有纤维化过程中的预后价值。材料和方法。78人接受了检查:47人来自主要组,19名(40.4%)女性和28名(59.6%)男性患有慢性HCV, 31名对照组,17名(54.8%)女性和14名(45.2%)男性没有慢性HCV。定量和定性测量分别计算中位数、25.0%和75.0%四分位数和相对值。预测因子采用逻辑回归分析确定。结果。单因素分析数据显示,慢性HCV背景下发生肝纤维化的风险显著增加,丙氨酸转氨酶(ALT)水平增加1.037倍,天冬氨酸转氨酶(AST)水平增加1.051倍,γ -谷氨酰转移酶(GGT)水平增加1.017倍;百里酚浊度试验1.424次;总蛋白增加1.162倍,OP增加3.002倍。随着甘油三酯和极低密度脂蛋白水平的增加,这些风险分别显著降低了74.7%和94.7%。一项多因素分析发现,在慢性HCV背景下,AST、总蛋白和OP水平较高,发生肝纤维化的风险显著增加(分别是1.028倍、1.195倍和2.510倍)。结论。与0-2期相比,在纤维化过程中肝损伤明显(3-4期)时,HCV患者血液中的肝脏生化标志物:ALT、AST、GGT、总蛋白和OP可能占优势。AST、总蛋白和OP被认为是肝纤维化的可靠预测指标。建立的数学模型具有较高的灵敏度和特异度,分别为87.5%和83.9%。
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来源期刊
CiteScore
0.30
自引率
0.00%
发文量
26
审稿时长
10 weeks
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