Five fibrosis biomarkers together with serum ferritin level to diagnose liver fibrosis and cirrhosis

Said M. Afify, Ashraf Tabll, Hend M. Nawara, Mohamed El Kassas, Ashraf Elfert, Masaharu Seno, Salah El-Kousy

Research output: Contribution to journalArticle

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Abstract

Background: Liver fibrosis is a dynamic procedure that results from an irregularity between fibrogenesis and fi-brolysis. After time this procedure can lead to cirrhosis of the liver. Liver fibrosis and cirrhosis assessment is very important for both therapeutic decisions and prognostic evaluations. In this study, we tried to use serum ferritin (SF) together with five fibrosis tests (Age-Platelet index (API), aspartate aminotransferase to alanine aminotransferase ratio (AAR), AST to platelet ratio index (APRI), Fibrosis 4 score (FIB-4), and fibro-quotient (Fibro-Q)) to assess liver fibrosis and cirrhosis and estimate possible correlation between inflammation and SF. Methods: This study was carried out on eighty-eight patients infected with HCV and twenty healthy subjects as a control. Complete blood count (CBC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), anti-HCV antibody, detection of HCV RNA by real-time PCR, and serum ferritin (SF) were assessed. Then API, ARR, APRI, FIB-4, and Fibro-Q were calculated. Different fibrosis stages (mild fibrosis stage (F1), moderate fibrosis stage (F2), severe fibrosis stage (F3), cirrhotic stage (F4)) were assessed using transient elastography by Fibro Scan®. Results: FIB-4 index was significantly elevated (p < 0.01) with the progression of liver fibrosis at F1, F2, F3, and F4 when compared to healthy control group. The APRI score elevation between F0 and F3 and between F0 and F4 was significant (p < 0.01). SF was elevated in all fibrosis stages and significantly (p < 0.01) at F3 and F4 compared to controls. Conclusions: APRI coupled with SF should be the best reliable biomarkers for liver cirrhosis. Simultaneously, from our data SF involved in all stages of inflammation. Therefore, down regulation of ferritin in the early stage of fibrosis should be helpful in decreasing the inflammatory effect of ferritin.

Original languageEnglish
Pages (from-to)1685-1693
Number of pages9
JournalClinical Laboratory
Volume64
Issue number10
DOIs
Publication statusPublished - Jan 1 2018

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Biomarkers
Ferritins
Liver Cirrhosis
Liver
Fibrosis
Platelets
Serum
Blood Platelets
Aspartate Aminotransferases
Alanine Transaminase
Hepatitis C Antibodies
Inflammation
Elasticity Imaging Techniques
Blood Cell Count
Blood
RNA
Real-Time Polymerase Chain Reaction
Healthy Volunteers
Down-Regulation
Control Groups

Keywords

  • Biomarker
  • Ferritin
  • Inflammation
  • Liver fibrosis

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Five fibrosis biomarkers together with serum ferritin level to diagnose liver fibrosis and cirrhosis. / Afify, Said M.; Tabll, Ashraf; Nawara, Hend M.; El Kassas, Mohamed; Elfert, Ashraf; Seno, Masaharu; El-Kousy, Salah.

In: Clinical Laboratory, Vol. 64, No. 10, 01.01.2018, p. 1685-1693.

Research output: Contribution to journalArticle

Afify, SM, Tabll, A, Nawara, HM, El Kassas, M, Elfert, A, Seno, M & El-Kousy, S 2018, 'Five fibrosis biomarkers together with serum ferritin level to diagnose liver fibrosis and cirrhosis', Clinical Laboratory, vol. 64, no. 10, pp. 1685-1693. https://doi.org/10.7754/Clin.Lab.2018.180502
Afify, Said M. ; Tabll, Ashraf ; Nawara, Hend M. ; El Kassas, Mohamed ; Elfert, Ashraf ; Seno, Masaharu ; El-Kousy, Salah. / Five fibrosis biomarkers together with serum ferritin level to diagnose liver fibrosis and cirrhosis. In: Clinical Laboratory. 2018 ; Vol. 64, No. 10. pp. 1685-1693.
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AU - Afify, Said M.

AU - Tabll, Ashraf

AU - Nawara, Hend M.

AU - El Kassas, Mohamed

AU - Elfert, Ashraf

AU - Seno, Masaharu

AU - El-Kousy, Salah

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N2 - Background: Liver fibrosis is a dynamic procedure that results from an irregularity between fibrogenesis and fi-brolysis. After time this procedure can lead to cirrhosis of the liver. Liver fibrosis and cirrhosis assessment is very important for both therapeutic decisions and prognostic evaluations. In this study, we tried to use serum ferritin (SF) together with five fibrosis tests (Age-Platelet index (API), aspartate aminotransferase to alanine aminotransferase ratio (AAR), AST to platelet ratio index (APRI), Fibrosis 4 score (FIB-4), and fibro-quotient (Fibro-Q)) to assess liver fibrosis and cirrhosis and estimate possible correlation between inflammation and SF. Methods: This study was carried out on eighty-eight patients infected with HCV and twenty healthy subjects as a control. Complete blood count (CBC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), anti-HCV antibody, detection of HCV RNA by real-time PCR, and serum ferritin (SF) were assessed. Then API, ARR, APRI, FIB-4, and Fibro-Q were calculated. Different fibrosis stages (mild fibrosis stage (F1), moderate fibrosis stage (F2), severe fibrosis stage (F3), cirrhotic stage (F4)) were assessed using transient elastography by Fibro Scan®. Results: FIB-4 index was significantly elevated (p < 0.01) with the progression of liver fibrosis at F1, F2, F3, and F4 when compared to healthy control group. The APRI score elevation between F0 and F3 and between F0 and F4 was significant (p < 0.01). SF was elevated in all fibrosis stages and significantly (p < 0.01) at F3 and F4 compared to controls. Conclusions: APRI coupled with SF should be the best reliable biomarkers for liver cirrhosis. Simultaneously, from our data SF involved in all stages of inflammation. Therefore, down regulation of ferritin in the early stage of fibrosis should be helpful in decreasing the inflammatory effect of ferritin.

AB - Background: Liver fibrosis is a dynamic procedure that results from an irregularity between fibrogenesis and fi-brolysis. After time this procedure can lead to cirrhosis of the liver. Liver fibrosis and cirrhosis assessment is very important for both therapeutic decisions and prognostic evaluations. In this study, we tried to use serum ferritin (SF) together with five fibrosis tests (Age-Platelet index (API), aspartate aminotransferase to alanine aminotransferase ratio (AAR), AST to platelet ratio index (APRI), Fibrosis 4 score (FIB-4), and fibro-quotient (Fibro-Q)) to assess liver fibrosis and cirrhosis and estimate possible correlation between inflammation and SF. Methods: This study was carried out on eighty-eight patients infected with HCV and twenty healthy subjects as a control. Complete blood count (CBC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), anti-HCV antibody, detection of HCV RNA by real-time PCR, and serum ferritin (SF) were assessed. Then API, ARR, APRI, FIB-4, and Fibro-Q were calculated. Different fibrosis stages (mild fibrosis stage (F1), moderate fibrosis stage (F2), severe fibrosis stage (F3), cirrhotic stage (F4)) were assessed using transient elastography by Fibro Scan®. Results: FIB-4 index was significantly elevated (p < 0.01) with the progression of liver fibrosis at F1, F2, F3, and F4 when compared to healthy control group. The APRI score elevation between F0 and F3 and between F0 and F4 was significant (p < 0.01). SF was elevated in all fibrosis stages and significantly (p < 0.01) at F3 and F4 compared to controls. Conclusions: APRI coupled with SF should be the best reliable biomarkers for liver cirrhosis. Simultaneously, from our data SF involved in all stages of inflammation. Therefore, down regulation of ferritin in the early stage of fibrosis should be helpful in decreasing the inflammatory effect of ferritin.

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