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https://doi.org/10.14300/mnnc.2024.19029

Significant fibrosis in chronic liver diseases: possibilities of noninvasive screening

[T h e r a p y]
Pavel Koroy; Temirlan Ruslanovich Dudov; Vijaya Sarithala; Alexandr Yagoda;

The investigation aimed to study the prognostic significance of clinical and laboratory parameters, including markers of the matrix metalloproteinases (MMP) system, for the detection of significant fibrosis (F2–4) in chronic liver diseases (CLD). Seventy-six patients with CLD of viral or alcoholic etiology aged 18 to 64 years were examined. Fibrosis F0–1 was found in 36.8 % of cases, and fibrosis F2–4 – in 63.2 %. Enzyme-linked immunosorbent assay was used to determine the blood levels of MMP-1, MMP-9, and tissue inhibitors of matrix metalloproteinases-1 (TIMP-1). The ratio TIMP-1/MMP-1, TIMP-1/MMP-9 was calculated. Increased risk of fibrosis F2–4 was associated with parameters of liver stiffness ≥7.3 kPa, gamma-glutamyltranspeptidase ≥37 u/l, aspartate aminotransferase ≥53 u/l, ESR ≥8 mm/h, platelets ≤187х109/l, age ≥45 years, alanine aminotransferase ≥68 u/l, TIMP-1/MMP-1 ≥36.4, albumin ≤43 g/l, total bilirubin ≥16 µmol/l, TIMP-1 ≥501 ng/ml, international normalized ratio ≥1.08, alkaline phosphatase ≥112 u/l, with the presence of moderate/severe cytolysis. According to multivariate logistic regression, liver fibrosis F2–4 was associated with blood levels of TIMP-1 and platelets, values of ESR. The combination of these parameters had a sensitivity of 70.8 % and a specificity of 100 % in the prediction of fibrosis F2–4. Thus, the levels of TIMP-1 and platelets in the blood and ESR are independent risk factors for significant fibrosis in CLD due to their participation in hepatic fibrogenesis.

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Keywords: chronic liver diseases, significant liver fibrosis, matrix metalloproteinases, tissue inhibitors of matrix metalloproteinases, platelets, erythrocyte sedimentation rate, screening