SNFGE SNFGE
 
Thématique :
- Foie
Originalité :
Réexamen
Solidité :
A confirmer
Doit faire évoluer notre pratique :
Pas encore
 
 
Nom du veilleur :
Professeur Christine SILVAIN
Coup de coeur :
 
 
Hepatology
  2015/11  
 
  2015 Nov;62(5):1433-43  
  doi: 10.1002/hep.28002  
 
  A novel noninvasive diagnostic method for nonalcoholic steatohepatitis using two glycobiomarkers  
 
  Kamada Y, Ono M, Hyogo H, Fujii H, Sumida Y, Mori K, Tanaka S, Yamada M, Akita M, Mizutani K, Fujii H, Yamamoto A, Takamatsu S, Yoshida Y, Itoh Y, Kawada N, Chayama K, Saibara T, Takehara T, Miyoshi E  
  http://www.ncbi.nlm.nih.gov/pubmed/?term=A+novel+noninvasive+diagnostic+method+for+nonalcoholic+steatohepatitis+using+two+glycobiomarkers  
 
 

Nonalcoholic fatty liver disease (NAFLD) is a growing medical problem; thus, discriminating nonalcoholic steatohepatitis (NASH) from NAFLD is of great clinical significance. For the diagnosis of NASH, liver biopsy-proven histological examination is the current gold standard, and noninvasive and reliable biomarkers are greatly needed. Recently, we found that two glycobiomarkers, fucosylated haptoglobin (Fuc-Hpt) and Mac-2 binding protein (Mac2bp), are useful independently for NASH diagnosis. In this study, we confirmed that serum Fuc-Hpt is suitable for the prediction of ballooning hepatocytes and that serum Mac2bp is suitable for the prediction of liver fibrosis severity in 124 biopsy-proven NAFLD patients (training cohort). In addition, we found that the combination of serum Fuc-Hpt and Mac2bp levels was an excellent tool for NASH diagnosis. Using receiver operating characteristic analyses, the area under the receiver operating characteristic curve, sensitivity, and specificity of the combination of these two glycobiomarkers were 0.854, 81.1%, and 79.3%, respectively. We established a prediction model for NASH diagnosis using logistic regression analysis: logit (p) = -2.700 + 0.00242 × Fuc-Hpt + 1.225 × Mac2bp. To validate the prediction model, another 382 biopsy-proven NAFLD patients were enrolled (validation cohort). In the validation cohort, the area under the receiver operating characteristic curve of this model for NASH diagnosis was 0.844, with 71.4% and 82.3% sensitivity and specificity, respectively. In addition, we investigated the significance of our developed NASH diagnosis model in ultrasound-diagnosed NAFLD subjects who received medical health checkups (n = 803). Our model also could predict NAFLD disease severity in this larger population.

CONCLUSION:

The combination of serum Fuc-Hpt and Mac2bp can distinguish NASH from NAFLD patients. Our noninvasive model using two serum glycobiomarkers contributes to a novel NASH diagnostic methodology that could replace liver biopsy. (Hepatology 2015;62:1433-1443).

 
Question posée
 
Est-ce que les glycobiomarqueurs, fucosylated haptoglobin (Fuc-Hpt) et Mac-2 binding protein (Mac2bp), sont utilisables indépendamment pour le diagnostic de NASH ?
 
Question posée
 
Les auteurs confirment que le dosage sérique de Fuc-Hpt est un facteur prédictif de la ballonisation des hépatocytes et que le dosage sérique de Mac2pb est un facteur prédictif de la fibrose hépatique chez les patients ayant une NLFD prouvée histologiquement. L’association des 2 est prédictive de la NASH avec un AUROC à 0,854. Dans la cohorte de validation l’AUROC est de 0,844.
 
Commentaires

Des résultats encourageants mais à valider dans des cohortes européennes et donc la PBH reste le Gold Standard pour le diagnostic de NASH.

 
www.snfge.org