COMPARISON OF 6 SERUM MARKERS OF HEPATIC- FIBROSIS IN PATIENTS WITH ALCOHOLIC LIVER-DISEASE

The aim of this study was to compare 6 potential serum markers for hep atic fibrosis in patients with alcoholic liver disease. Ninety-three p atients (50 +/- 11 years old, 62 males) with biopsy-proven alcoholic l iver disease were included in the study. A liver biopsy and serum assa ys of type I, type III and type IV collagens, N-terminal peptide of ty pe III procollagen, laminin (by radioimmunoassays) and apolipoprotein Al (by nephelometry) were performed in all patients. A histological sc ore of hepatic fibrosis was established. Alcoholic hepatitis lesions a nd perisinusoidal fibrosis were assessed separately. A significant cor relation was found between the score of hepatic fibrosis and serum lev els of type I collagen (r = 0.44, P < 10(-3)), type III collagen (r = 0.36, P < 10(-2)), N-terminal peptide of type Ill procollagen (r = 0.5 0, P < 10(-3)), type IV collagen (r = 0.44, P < 10(-3)), laminin (r = 0.50, P < 10(-3)), and apolipoprotein Al (r = 0.21, P < 0.05). After a djustement for the presence of lesions of alcoholic hepatitis and peri sinusoidal fibrosts (partial correlation), serum levels of type I coll agen, type III collagen, N-terminal peptide of type III procollagen, t ype IV collagen, and laminin remained significantly correlated with th e score of hepatic fibrosis; in contrast, correlation with serum apoli poprotein Al was no longer significant. Serum levels of N-terminal pep tide of type III procollagen, type IV collagen and laminin were signif icantly higher in patients with perisinusoidal fibrosis. No patients h ad cirrhosis when serum levels of type I collagen, type III collagen, serum N-terminal peptide of type III procollagen, type IV collagen, an d laminin were within normal ranges. In conclusion, our study suggests that all these markers, except apolipoprotein Al, could be used to as sess hepatic fibrosis, especially during therapeutic trials.