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Serum Immunoglobulin A Concentration Is an Independent Predictor of Liver Fibrosis in Nonalcoholic Steatohepatitis Before the Cirrhotic Stage

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Abstract

Background and Aims

The similarity of alcoholic liver disease and nonalcoholic steatohepatitis (NASH) in terms of pathogenic mechanisms suggests that immunoglobulin A (IgA) may play an important role in the pathogenesis of NASH. We aimed to determine whether serum IgA concentrations allow a diagnosis of liver fibrosis in NASH.

Methods

We compared serum IgA concentrations between 108 patients with stages 0–2 NASH and 19 patients with stage 3 NASH.

Results

In a univariate analysis, age (P < 0.0001), gender (P = 0.0039), serum albumin level (P = 0.0192), AST (P < 0.0001), AST/ALT ratio (P < 0.0001), platelet count (P = 0.0027), hyaluronic acid level (P < 0.0001), fasting blood sugar (FBS) (P = 0.0013), IRI (P = 0.0001), prothrombin time (%) (P = 0.0287), IgA (P < 0.0001), total sum of IgG, IgA, and IgM (P = 0.0049), and IgA/(IgG + IgA + IgM) (P = 0.0105) were significantly elevated in severe-stage NASH patients compared with the early-stage NASH group. Multiple logistic regression analysis showed that in severe-stage NASH patients, only serum IgA concentrations were significantly elevated (P = 0.0225) relative to early-stage NASH patients. The area under the curve (AUC) of serum IgA concentrations was 0.758 for detecting severe-stage NASH compared with early-stage NASH.

Conclusions

Serum IgA concentration could be a useful independent predictor for assessing the pre-cirrhotic progression of NASH.

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Abbreviations

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

IgA:

Immunoglobulin A

ALD:

Alcoholic liver disease

SD:

Standard deviation

ANOVA:

Analysis of variance

ROC:

Receiver operating characteristic

BMI:

Body mass index

FBS:

Fasting blood sugar.

AUC:

Area under the curve

IRI:

Immunoreactive insulin

AUC:

Area under the curve

PPV:

Positive predictive value

NPV:

Negative predictive value

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Acknowledgment

This study was supported in part by a grant from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Kengo Tomita, Toshiaki Teratani, Takahiro Suzuki, Hirotoshi Ebinuma & Toshifumi Hibi

  2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan

    Kengo Tomita, Ryota Hokari & Soichiro Miura

  3. Health Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Hirokazu Yokoyama

  4. Department of Pathology, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki-shi, Kanagawa, 210-0013, Japan

    Rie Irie

  5. Graduate School of Pharmaceutical Sciences, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan

    Hidetsugu Saito

Authors
  1. Kengo Tomita
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  2. Toshiaki Teratani
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  3. Hirokazu Yokoyama
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  4. Takahiro Suzuki
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  5. Rie Irie
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  6. Hirotoshi Ebinuma
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  7. Hidetsugu Saito
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  8. Ryota Hokari
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  9. Soichiro Miura
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  10. Toshifumi Hibi
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Correspondence to Toshifumi Hibi.

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Tomita, K., Teratani, T., Yokoyama, H. et al. Serum Immunoglobulin A Concentration Is an Independent Predictor of Liver Fibrosis in Nonalcoholic Steatohepatitis Before the Cirrhotic Stage. Dig Dis Sci 56, 3648–3654 (2011). https://doi.org/10.1007/s10620-011-1771-2

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  • DOI: https://doi.org/10.1007/s10620-011-1771-2

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