Procalcitonin as a Predictive Marker of Incident Liver Disease

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver International Pub Date : 2025-05-12 DOI:10.1111/liv.70132

Amanda Finnberg-Kim, Mats Pihlsgård, Kristina Önnerhag, Olle Melander, Sofia Enhörning

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Abstract

Background and Aims

Previous studies have shown that procalcitonin (PCT) concentration is elevated in patients with liver disease without evidence of bacterial infection. We aimed to investigate the association between elevated PCT and the future risk of liver disease.

Method

PCT was measured in 3897 individuals without known liver disease in the Malmö Diet and Cancer Cardiovascular Cohort (MDC-CC) and in 3854 individuals in the Malmö Preventive Project cohort (MPP). Cox proportional hazards regression models were used to analyse the risk of register-verified incident liver disease by PCT levels. We performed our analyses in a pooled sample of both the MPP and MDC-CC cohorts, as well as separate analyses for each cohort.

Results

70 subjects in MDC-CC and 49 subjects in MPP were diagnosed with non-viral liver disease during a median follow-up of 27.1 and 14.8 years, respectively. In multivariate adjusted models in the pooled sample, individuals with high PCT (> 0.05 ng/mL) had a significantly increased risk of developing liver disease compared to subjects with PCT concentrations below the cutoff (hazard ratio (HR) 3.4, 95% confidence interval (CI) 2.07–5.63, p < 0.001). The HR per standard deviation increase of log-transformed PCT was 1.56 (95% CI 1.32–1.85, p < 0.001) in multivariate adjusted models. Separate cohort-specific sensitivity analyses, including additional adjustment for C-reactive protein, showed similar effect estimates as the pooled analyses.

Conclusions

Elevated concentration of PCT independently predicts non-viral liver disease. These findings could have implications for risk assessment but also highlight the possibility of PCT as a direct cause of hepatocyte damage.

Abstract Image

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降钙素原作为肝脏疾病发生的预测指标

背景和目的先前的研究表明，在没有细菌感染证据的肝病患者中，降钙素原（PCT）浓度升高。我们的目的是调查PCT升高与肝脏疾病未来风险之间的关系。方法对Malmö饮食与癌症心血管队列（MDC-CC）中3897例无肝脏疾病的患者和Malmö预防项目队列（MPP）中3854例患者进行PCT检测。采用Cox比例风险回归模型分析经登记验证的PCT水平对肝脏疾病发生率的影响。我们在MPP和MDC-CC队列的合并样本中进行了分析，并对每个队列进行了单独的分析。结果70例MDC-CC和49例MPP在中位随访期间分别被诊断为非病毒性肝病，随访时间分别为27.1年和14.8年。在合并样本的多变量调整模型中，与PCT浓度低于临界值的受试者相比，PCT浓度高（0.05 ng/mL）的个体发生肝脏疾病的风险显著增加（风险比（HR） 3.4, 95%置信区间（CI） 2.07-5.63, p < 0.001）。在多变量调整模型中，对数变换PCT的每标准差增加的HR为1.56 （95% CI 1.32-1.85, p < 0.001）。单独的队列特异性敏感性分析，包括额外的c反应蛋白调整，显示出与合并分析相似的效果估计。结论PCT浓度升高可独立预测非病毒性肝病。这些发现可能对风险评估有影响，但也强调了PCT作为肝细胞损伤的直接原因的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.