Correlation of serum Mac-2-binding protein glycosylation isomer (M2BPGi) and liver stiffness in chronic hepatitis B infection
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Background and aim
Mac-2-binding protein glycosylation isomer (M2BPGi) is a novel serum diagnostic marker for liver fibrosis in various liver diseases. We aimed to evaluate its role in assessment of liver fibrosis in chronic hepatitis B infection (CHB) with reference to liver stiffness measurement (LSM).
CHB patients with LSM by transient elastography technology and retrievable serum samples were recruited. Ten-year re-assessments of LSM and M2BPGi were repeated in a patient subgroup.
240 CHB patients (M:F = 116:124; median age 47.5 years) were recruited. The median M2BPGi values for F0/F1/F2, F3 and F4 progressively increased with more advanced stages of liver fibrosis: 0.39, 0.46 and 0.82 COI, respectively (p < 0.01). M2BPGi levels correlated well with liver stiffness (r = 0.611), FIB-4 (r = 0.616), and strongly with APRI (r = 0.825) (all p < 0.001). Using cut-off values of 0.605 and 0.615 COI, the AUROCs were 0.754 and 0.799 for ≥ F3 and F4, respectively. M2BPGi identified one-quarter patients at risk of advanced fibrosis/cirrhosis otherwise classified into ‘grey area’ by LSM. In 86 patients with reassessment LSM, 21 (24.4%) showed significant fibrosis regression with corresponding decline in median M2BPGi level (− 0.11 COI) compared with the increase of +0.03 COI in patients without significant fibrosis regression (p = 0.011). Male gender, older age, use of potent antiviral therapy and change in serum M2BPGi were independently associated with significant fibrosis regression.
Serum M2BPGi can risk-stratify CHB patients whose liver stiffness fell into the ‘grey area’. Significant fibrosis regression occurring in one-quarter patients was reflected by a reduction in M2BPGi levels at 10-year interval.
KeywordsCirrhosis Elastography Hepatitis B Liver fibrosis M2BPGi
We would like to thank Sysmex Corp. for supporting the measurement of M2BPGi and Health-Tech for performing the measurement.
LYM was involved in drafting the manuscript. DKHW was involved in performing laboratory tests and collecting the data. WKS, QN and JF were involved in interpretation of the data and critical revision of the manuscript. KSC was involved in analysis of data. CLL was involved in critical revision of the manuscript. MFY was involved in study concept and design, analysis and interpretation of data, critical revision of manuscript, and overall study supervision. All authors have approved the final draft submitted.
Compliance with ethical standards
Conflict of interest
No potential conflicts of interest to disclose for the authors Lung-Yi Mak, Danny Ka-Ho Wong, Wai-Kay Seto, Qin Ning, Ka-Shing Cheung, James Fung, Ching-Lung Lai, and Man-Fung Yuen.
This study was approved by the Institutional Review Board/Ethics Committee of the University of Hong Kong and the Hong Kong West Cluster of Hospital Authority.
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