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Erschienen in:
01.12.2011 | Original Article
Serum Immunoglobulin A Concentration Is an Independent Predictor of Liver Fibrosis in Nonalcoholic Steatohepatitis Before the Cirrhotic Stage
Erschienen in: Digestive Diseases and Sciences | Ausgabe 12/2011
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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.