Plasma N-terminal propeptide of type III procollagen accurately predicts liver fibrosis severity in children with non-alcoholic fatty liver disease

摘要

Background & Aims We examined the diagnostic performance of plasma N-terminal propeptide of type III procollagen (PIIINP) levels, aspartate aminotransferase to platelet ratio index (APRI) and Fibrosis-4 (FIB-4) score for predicting non-alcoholic steatohepatitis (NASH) and liver fibrosis stage in children/adolescents with non-alcoholic fatty liver disease (NAFLD). Methods We enrolled 204 children/adolescents with biopsy-proven NAFLD at the "Bambino Gesu" Children's Hospital. We measured plasma PIIINP levels using a commercially available enzyme-linked immunosorbent assay kit and calculated APRI and FIB-4 scores using standard methods. Results Children with NASH had higher plasma PIIINP levels, APRI and FIB-4 scores compared with those without NASH (all P = 2 fibrosis progressively increased with increasing PIIINP levels (P = 2 fibrosis increased by similar to 14-fold (adjusted-odds ratio 14.1, 95% CI 5.50-35.8, P = 2 fibrosis, and 0.993 (95% CI 0.98-1.0) for F3 fibrosis respectively. Conclusions Unlike APRI and FIB-4 scores, plasma PIIINP levels are a promising, non-invasive biomarker for diagnosing liver fibrosis stage in children/adolescents with biopsy-proven NAFLD.