Journal of Gastroenterology

, Volume 52, Issue 2, pp 245–252 | Cite as

Serum Mac-2 binding protein glycosylation isomer predicts grade F4 liver fibrosis in patients with biliary atresia

  • Naoya YamadaEmail author
  • Yukihiro Sanada
  • Masahisa Tashiro
  • Yuta Hirata
  • Noriki Okada
  • Yoshiyuki Ihara
  • Taizen Urahashi
  • Koichi Mizuta
Original Article—Liver, Pancreas, and Biliary Tract


Background and Aim

Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) is a novel fibrosis marker. We examined the ability of M2BPGi to predict liver fibrosis in patients with biliary atresia.


Sixty-four patients who underwent living donor liver transplantation (LDLT) were included [median age, 1.1 years (range 0.4–16.0), male 16 patients (25.0 %)]. We examined M2BPGi levels in serum obtained the day before LDLT, and we compared the value of the preoperative M2BPGi levels with the histological evaluation of fibrosis using the METAVIR fibrosis score. Subsequently, we assessed the ability of M2BPGi levels to predict fibrosis.


The median M2BPGi level in patients with BA was 6.02 (range, 0.36–20.0), and 0, 1, 1, 11, and 51 patients had METAVIR fibrosis scores of F0, F1, F2, F3, and F4, respectively. In patients with F4 fibrosis, the median M2BPGi level was 6.88 (quartile; 5.235, 12.10), significantly higher than that in patients with F3 fibrosis who had a median level of 2.42 (quartile; 1.93, 2.895, p < 0.01). Area under the curve analysis for the ability of M2BPGi level to predict grade fibrosis was 0.917, with a specificity and sensitivity of 0.923 and 0.941, respectively. In comparison with other fibrosis markers such as hyaluronic acid, procollagen-III-peptide, type IV collagen 7 s, and aspartate aminotransferase platelet ratio index, M2BPGi showed the strongest ability to predict grade F4 fibrosis.


M2BPGi is a novel fibrosis marker for evaluating the status of the liver in patients with BA, especially when predicting grade F4 fibrosis.


Liver fibrosis Mac-2 binding protein glycosylation isomer Biliary atresia 



Aspartate aminotransferase platelet ratio index


Area under the curve


Biliary atresia


Liver biopsy


Living donor liver transplantation




Receiver operating characteristics


Mac-2 binding protein glycosylation isomer



We thank Sysmex Co., Hyogo, Japan, which provided all materials and strategies for examination of M2BPGi.

Compliance with ethical standards

Conflict of interest

The authors declare that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript.


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Copyright information

© Japanese Society of Gastroenterology 2016

Authors and Affiliations

  • Naoya Yamada
    • 1
    Email author
  • Yukihiro Sanada
    • 1
  • Masahisa Tashiro
    • 1
  • Yuta Hirata
    • 1
  • Noriki Okada
    • 1
  • Yoshiyuki Ihara
    • 1
  • Taizen Urahashi
    • 1
  • Koichi Mizuta
    • 1
  1. 1.Department of Transplant SurgeryJichi Medical UniversityTochigiJapan

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