A Novel Fibrosis Index Comprising a Non-Cholesterol Sterol Accurately Predicts HCV-Related Liver Cirrhosis
Journal article, 2014
Diagnosis of liver cirrhosis is essential in the management of chronic hepatitis C virus (HCV) infection. Liver biopsy is invasive and thus entails a risk of complications as well as a potential risk of sampling error. Therefore, non-invasive diagnostic tools are preferential. The aim of the present study was to create a model for accurate prediction of liver cirrhosis based on patient characteristics and biomarkers of liver fibrosis, including a panel of non-cholesterol sterols reflecting cholesterol synthesis and absorption and secretion. We evaluated variables with potential predictive significance for liver fibrosis in 278 patients originally included in a multicenter phase III treatment trial for chronic HCV infection. A stepwise multivariate logistic model selection was performed with liver cirrhosis, defined as Ishak fibrosis stage 5-6, as the outcome variable. A new index, referred to as Nordic Liver Index (NoLI) in the paper, was based on the model:Log-odds (predicting cirrhosis) =-12.17+ (agex0.11) + (BMI (kg/m(2))x0.23) + (D-7-lathosterol (mu g/100 mg cholesterol)x(-0.013)) + (Platelet count (x10(9)/L)x(-0.018)) + (Prothrombin-INRx3.69). The area under the ROC curve (AUROC) for prediction of cirrhosis was 0.91 (95% CI 0.86-0.96). The index was validated in a separate cohort of 83 patients and the AUROC for this cohort was similar (0.90; 95% CI: 0.82-0.98). In conclusion, the new index may complement other methods in diagnosing cirrhosis in patients with chronic HCV infection.
1988
JOURNAL OF LIPID RESEARCH
TRANSIENT ELASTOGRAPHY
CHRONIC VIRAL-HEPATITIS
ETTINEN TA
STEATOSIS
INSULIN-RESISTANCE
V131
ETTINEN TA
V29
AMERICAN JOURNAL OF EPIDEMIOLOGY
VIRUS-INFECTION
P20
TESTS
P43
CHRONIC HEPATITIS-C
1990
STANDARD LABORATORY
TRANSPLANTATION
SERUM MARKERS
PRIMARY BILIARY-CIRRHOSIS
Author
Magdalena Ydreborg
University of Gothenburg
Vera Lisovskaja
University of Gothenburg
Chalmers, Mathematical Sciences, Mathematical Statistics
Martin Lagging
University of Gothenburg
Peer B Christensen
Odense Universitetshospital
Nina Langeland
University of Bergen
Mads Rauning Buhl
Aarhus University
Court Pedersen
Odense Universitetshospital
Kristine Mørch
University of Bergen
Rune Wejstål
University of Gothenburg
Gunnar Norkrans
University of Gothenburg
Magnus Lindh
University of Gothenburg
Martti Färkkilä
University of Helsinki
Johan Westin
University of Gothenburg
PLoS ONE
1932-6203 (ISSN) 19326203 (eISSN)
Vol. 9 4 artikel nr e93601- e93601Subject Categories
Infectious Medicine
DOI
10.1371/journal.pone.0093601