Key result
Plasma M30 shows poor accuracy for predicting NASH in NAFLD compared to routine AST.
Why the study?
Does plasma M30 provide better diagnostic accuracy for detecting NASH compared to routine biochemical markers in patients with NAFLD?
Cross-Sectional (n=113)
Single-blind
Yes
Does plasma M30 provide better diagnostic accuracy for detecting NASH compared to routine biochemical markers in patients with NAFLD?
Effect estimate: AUROC 0.59
Absolute Event Rate: 0.59% vs 0.75%
Plasma M30 has limited utility for detecting NASH in clinical practice compared to routine biochemical markers like AST and ALT.
M30 lacks utility versus AST for NASH detection in NAFLD; leaves open identification of accurate noninvasive biomarkers.
INTRODUCTION: The utility of Cytokeratin-18 fragment, namely CK18Asp396 (M30), for the diagnosis of non-alcoholic steatohepatitis (NASH) is currently uncertain. We aimed to provide further data in this area among multi-ethnic Asian subjects with NAFLD. MATERIALS AND METHODS: The accuracy of M30 for detecting NASH was compared with serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transpeptidase (GGT) levels in consecutive adult subjects with biopsy-proven non-alcoholic fatty liver disease (NAFLD). RESULTS: Data for 93 NAFLD subjects (mean age 51.0 ± 11.1 years old and 51.6% males) and 20 healthy controls (mean age 50.2 ± 16.4 years old and 33.3% males) were analyzed. There were 39 NASH subjects (41.9%) and 54 non-NASH subjects (58.1%) among the NAFLD subjects. Plasma M30 (349 U/L vs. 162 U/L), and serum ALT (70 IU/L vs. 26 IU/L), AST (41 IU/L vs. 20 IU/L) and GGT (75 IU/L vs. 33 IU/L) were significantly higher in NAFLD subjects than in healthy controls. Serum ALT (86 IU/L vs. 61 IU/L), AST (58 IU/L vs. 34 IU/L) and GGT (97 IU/L vs. 56 IU/L) were significantly higher in NASH subjects compared to non-NASH subjects, but no significant difference was observed with plasma M30 (435 U/L vs. 331 U/L). The accuracy of plasma M30, and serum ALT, AST and GGT was good for predicting NAFLD (AUROC 0.91, 0.95, 0.87 and 0.85, respectively) but less so for NASH (AUROC 0.59, 0.64, 0.75 and 0.68, respectively). Serum ALT and AST, but not plasma M30 showed a significant trend with increasing grades of ballooning and lobular inflammation. CONCLUSION: The utility of M30 in the detection of NASH in clinical practice appears limited, in comparison to routine biochemical markers.
No takes yet. Share an insight, caveat, or question.
Chan et al. (2014) conducted a cross-sectional in Non-alcoholic fatty liver disease (NAFLD) and Non-alcoholic steatohepatitis (NASH) (n=113). Plasma M30 (CK18Asp396) vs. Routine biochemical markers (ALT, AST, GGT) was evaluated on Accuracy (AUROC) for predicting NASH among NAFLD subjects (AUROC 0.59). Plasma M30 demonstrated poor accuracy for predicting NASH among NAFLD subjects (AUROC 0.59), offering limited clinical utility compared to routine biochemical markers such as serum AST (AUROC 0.75).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: