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首页> 外文期刊>European journal of gastroenterology and hepatology >The diagnostic value of combining carbohydrate-deficient transferrin, fibrosis, and steatosis biomarkers for the prediction of excessive alcohol consumption.
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The diagnostic value of combining carbohydrate-deficient transferrin, fibrosis, and steatosis biomarkers for the prediction of excessive alcohol consumption.

机译：结合碳水化合物不足的转铁蛋白，纤维化和脂肪变性生物标志物的诊断价值，可用于预测过量饮酒。

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BACKGROUND AND AIM: The validity of biomarkers of excessive alcohol drinking (EAD) (30 g/day or more), such as carbohydrate-deficient transferrin (CDT%), is confounded by liver disease severity. The aim was to improve the accuracy of the percentage of CDT by taking into account the presence of fibrosis and steatosis, estimated using biomarkers FibroTest and SteatoTest. METHODS: Three hundred and twenty consecutive patients, 97 with alcoholic liver disease (ALD), and 223 non-ALD, were included. In ALD, 58% had advanced fibrosis and 58% had steatosis; in non-ALD, 25% had advanced fibrosis and 25% had steatosis. RESULTS: The mean percentage of CDT was lower in ALD with advanced fibrosis [2.4 (SE=0.2)] versus without [4.1 (0.3) P<0.0001], and lower in ALD with steatosis versus without (2.4 vs. 3.9; P=0.0007). Among non-ALD, there was no difference in the percentage of CDT according to fibrosis or steatosis. gamma-glutamyl-transpeptidase was higher in patients with advanced fibrosis or with steatosis both in ALD and non-ALD. Aspartate aminotransferase/alanine aminotransferase (AST/ALT) was higher in ALD patients with fibrosis versus without (2.5 vs. 1.3 P<0.0001) but not in non-ALD (1.01 vs. 0.98). AST/ALT was higher in ALD patients with steatosis versus without (2.2 vs. 1.6 P=0.04) and the inverse was observed in non-ALD (0.6 vs. 1.1 P<0.0001). In the entire population the percentage of CDT, gamma-glutamyl-transpeptidase, AST/ALT was associated with EAD, the area under the receiver operating characteristic curve =0.89 (95% CI: 0.84-0.93), 0.93 (0.89-0.93) and 0.77 (0.71-0.82). An algorithm combining the percentage of CDT, FibroTest and SteatoTest permitted to obtain area under the receiver operating characteristic curve=0.92 versus 0.88 for the percentage of CDT (P=0.004) with 87.4% of patients classified correctly. CONCLUSION: Biomarkers of EAD are confounded by fibrosis and steatosis. Accuracy of the percentage of CDT is significantly increased when combined with biomarkers of fibrosis and steatosis.
机译：背景与目的：过度饮酒（EAD）（30 g /天或以上）等生物标志物（如缺乏碳水化合物的转铁蛋白（CDT％））的有效性与肝脏疾病的严重程度相混淆。目的是通过考虑纤维化和脂肪变性的存在来提高CDT百分比的准确性，使用生物标志物FibroTest和SteatoTest进行评估。方法：纳入320例连续患者，其中97例患有酒精性肝病（ALD），而223例非ALD。在ALD中，58％患有晚期纤维化，58％患有脂肪变性。在非ALD患者中，有25％患有晚期纤维化，有25％患有脂肪变性。结果：晚期纤维化的ALD中CDT的平均百分比较低[2.4（SE = 0.2）]，而无纤维化的ALD中CDT的平均百分比[4.1（0.3）P <0.0001]，而脂肪变性的ALD中的CDT平均百分比较低（2.4 vs. 3.9; P = 0.0007）。在非ALD患者中，根据纤维化或脂肪变性的CDT百分比没有差异。在ALD和非ALD的晚期纤维化或脂肪变性患者中，γ-谷氨酰转肽酶较高。纤维化的ALD患者的天冬氨酸转氨酶/丙氨酸转氨酶（AST / ALT）高于无纤维化的ALD患者（2.5 vs. 1.3 P <0.0001），但非ALD患者则没有（1.01 vs. 0.98）。脂肪变性的ALD患者的AST / ALT高于无脂肪变性的AST / ALT（2.2 vs. 1.6 P = 0.04），而非ALD患者则相反（0.6 vs. 1.1 P <0.0001）。在整个人群中，CDT，γ-谷氨酰转肽酶，AST / ALT的百分比与EAD相关，接受者工作特征曲线下的面积= 0.89（95％CI：0.84-0.93），0.93（0.89-0.93）和0.77（0.71-0.82）。结合了CDT，FibroTest和SteatoTest百分比的算法允许在接收器工作特性曲线下获得面积（= 0.92对0.88），CDT百分比（P = 0.004）与87.4％的患者正确分类有关。结论：EAD的生物标志物与纤维化和脂肪变性混淆。当与纤维化和脂肪变性的生物标志物结合使用时，CDT百分比的准确性会大大提高。

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