1. Secondary bile acids improve risk prediction for non‐invasive identification of mild liver fibrosis in nonalcoholic fatty liver disease
- Author
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Liu, A‐Na, Xu, Cui‐Fang, Liu, Ya‐Ru, Sun, Dan‐Qin, Jiang, Ling, Tang, Liang‐Jie, Zhu, Pei‐Wu, Chen, Sui‐Dan, Liu, Wen‐Yue, Wang, Xiao‐Dong, Targher, Giovanni, Byrne, Christopher D, Wong, Vincent Wai‐Sun, Fu, Junfen, Su, Ming‐Ming, Loomba, Rohit, Zheng, Ming‐Hua, and Ni, Yan
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Digestive Diseases ,Chronic Liver Disease and Cirrhosis ,Liver Disease ,Good Health and Well Being ,Adult ,Male ,Humans ,Female ,Non-alcoholic Fatty Liver Disease ,Bile Acids and Salts ,Liver Cirrhosis ,Inflammation ,Biomarkers ,Obesity ,Liver ,liver fibrosis ,nonalcoholic fatty liver disease ,risk prediction ,secondary bile acids ,Pharmacology and Pharmaceutical Sciences ,Gastroenterology & Hepatology ,Clinical sciences ,Pharmacology and pharmaceutical sciences - Abstract
BackgroundDysregulated bile acid (BA) metabolism has been linked to steatosis, inflammation, and fibrosis in nonalcoholic fatty liver disease (NAFLD).AimTo determine whether circulating BA levels accurately stage liver fibrosis in NAFLD.MethodsWe recruited 550 Chinese adults with biopsy-proven NAFLD and varying levels of fibrosis. Ultra-performance liquid chromatography coupled with tandem mass spectrometry was performed to quantify 38 serum BAs.ResultsCompared to those without fibrosis, patients with mild fibrosis (stage F1) had significantly higher levels of secondary BAs, and increased diastolic blood pressure (DBP), alanine aminotransferase (ALT), body mass index, and waist circumstance (WC). The combination of serum BAs with WC, DBP, ALT, or Homeostatic Model Assessment for Insulin Resistance performed well in identifying mild fibrosis, in men and women, and in those with/without obesity, with AUROCs 0.80, 0.88, 0.75 and 0.78 in the training set (n = 385), and 0.69, 0.80, 0.61 and 0.69 in the testing set (n = 165), respectively. In comparison, the combination of BAs and clinical/biochemical biomarkers performed less well in identifying significant fibrosis (F2-4). In women and in non-obese subjects, AUROCs were 0.75 and 0.71 in the training set, 0.65 and 0.66 in the validation set, respectively. However, these AUROCs were higher than those observed for the fibrosis-4 index, NAFLD fibrosis score, and Hepamet fibrosis score.ConclusionsSecondary BA levels were significantly increased in NAFLD, especially in those with mild fibrosis. The combination of serum BAs and clinical/biochemical biomarkers for identifying mild fibrosis merits further assessment.
- Published
- 2023