{"title":"IV型胶原7S对代谢功能障碍相关脂肪变性肝病晚期纤维化的预测","authors":"Hiroshi Ishiba , Yoshio Sumida , Yoshihiro Kamada , Hideki Fujii , Michihiro Iwaki , Hideki Hayashi , Hidenori Toyoda , Satoshi Oeda , Hideyuki Hyogo , Miwa Kawanaka , Asahiro Morishita , Kensuke Munekage , Kazuhito Kawata , Tsubasa Tsutsumi , Koji Sawada , Tatsuji Maeshiro , Hiroshi Tobita , Yuichi Yoshida , Masafumi Naito , Asuka Araki , Takeshi Okanoue","doi":"10.1016/j.gastha.2025.100668","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Aims</h3><div>Type IV collagen 7S (COL4-7S) is a simple, noninvasive biomarker for liver fibrosis. However, whether COL4-7S can detect advanced fibrosis (AF) and predict the prognosis of metabolic dysfunction–associated steatotic liver disease (MASLD) is unclear. We examined the clinical efficacy of COL4-7S in diagnosing AF and determining MASLD prognosis.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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 (<em>P</em> = .009) and 27.9 (<em>P</em> < .001) compared with COL4-7S <4.8, and the adjusted hazard ratio of AF on liver biopsy was 1.6 (<em>P</em> = .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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 7","pages":"Article 100668"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prediction of Advanced Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease by Type IV Collagen 7S\",\"authors\":\"Hiroshi Ishiba , Yoshio Sumida , Yoshihiro Kamada , Hideki Fujii , Michihiro Iwaki , Hideki Hayashi , Hidenori Toyoda , Satoshi Oeda , Hideyuki Hyogo , Miwa Kawanaka , Asahiro Morishita , Kensuke Munekage , Kazuhito Kawata , Tsubasa Tsutsumi , Koji Sawada , Tatsuji Maeshiro , Hiroshi Tobita , Yuichi Yoshida , Masafumi Naito , Asuka Araki , Takeshi Okanoue\",\"doi\":\"10.1016/j.gastha.2025.100668\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and Aims</h3><div>Type IV collagen 7S (COL4-7S) is a simple, noninvasive biomarker for liver fibrosis. However, whether COL4-7S can detect advanced fibrosis (AF) and predict the prognosis of metabolic dysfunction–associated steatotic liver disease (MASLD) is unclear. We examined the clinical efficacy of COL4-7S in diagnosing AF and determining MASLD prognosis.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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 (<em>P</em> = .009) and 27.9 (<em>P</em> < .001) compared with COL4-7S <4.8, and the adjusted hazard ratio of AF on liver biopsy was 1.6 (<em>P</em> = .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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>\",\"PeriodicalId\":73130,\"journal\":{\"name\":\"Gastro hep advances\",\"volume\":\"4 7\",\"pages\":\"Article 100668\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastro hep advances\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S277257232500055X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastro hep advances","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S277257232500055X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Prediction of Advanced Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease by Type IV Collagen 7S
Background and Aims
Type IV collagen 7S (COL4-7S) is a simple, noninvasive biomarker for liver fibrosis. However, whether COL4-7S can detect advanced fibrosis (AF) and predict the prognosis of metabolic dysfunction–associated steatotic liver disease (MASLD) is unclear. We examined the clinical efficacy of COL4-7S in diagnosing AF and determining MASLD prognosis.
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.
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