Serum levels of YKL-40 and PIIINP as prognostic markers in patients with alcoholic liver disease

Nøjgaard, Camilla; Johansen, Julia S; Christensen, Erik; Skovgaard, Lene Theil; Price, Paul A; Becker, Ulrik; The EMALD Group,

doi:10.1016/S0168-8278(03)00184-3

« Previous Next »Journal of Hepatology
Volume 39, Issue 2 , Pages 179-186, August 2003

Serum levels of YKL-40 and PIIINP as prognostic markers in patients with alcoholic liver disease

Camilla Nøjgaard
- Department of Gastroenterology and Alcohol Unit, Hvidovre Hospital, Hvidovre, Denmark
- Department of Clinical Physiology and Nuclear Medicine, Hvidovre Hospital, Hvidovre, Denmark
- Corresponding author. Department of Medicine, Roskilde Amts Sygehus Køge, Lykkebækvej 1, 4600 Køge, Denmark
Julia S Johansen
- Department of Rheumatology, Hvidovre Hospital, Hvidovre, Denmark
Erik Christensen
- Clinic of Internal Medicine 1, Bispebjerg Hospital, Copenhagen, Denmark
Lene Theil Skovgaard
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
Paul A Price
- Department of Biology, University of California, San Diego, La Jolla, CA, USA
Ulrik Becker
- Department of Gastroenterology and Alcohol Unit, Hvidovre Hospital, Hvidovre, Denmark
The EMALD Group

Received 12 November 2002; received in revised form 18 March 2003; accepted 2 April 2003.

Abstract

Background/Aims: YKL-40 (growth factor) and PIIINP (N-terminal propeptide of Type III procollagen) are potential markers of liver fibrosis. The aim was to evaluate the prognostic value of serum YKL-40 and PIIINP levels in patients with alcoholic liver disease.

Methods: Three hundred and seventy patients with alcoholic liver disease were studied in a trial of malotilate with a median follow-up period of 470 days; 75 patients died; 336 patients had a liver biopsy on entry. Serum levels of YKL-40 and PIIINP were determined by radioimmunoassay (RIA).

Results: Serum YKL-40 and PIIINP were elevated in the patients compared to controls. Patients with steatosis or no fibrosis had the lowest serum levels of YKL-40 and PIIINP, whereas patients with alcoholic hepatitis and/or cirrhosis had the highest levels. Serum YKL-40 was associated with the presence of fibrosis, and serum PIIINP was also associated with the different grades of fibrosis. Patients with elevated serum YKL-40 or PIIINP had shorter survival than patients with normal serum levels of YKL-40 (P<0.0001) or PIIINP (P=0.044). High degree of fibrosis predicted shorter survival (P=0.004).

Conclusions: Serum levels of YKL-40 and PIIINP are elevated in alcoholic patients, related to the presence of liver fibrosis and may provide prognostic information.

Keywords: YKL-40, Human cartilage glycoprotein, PIIINP, N-terminal propeptide of Type III procollagen, Alcoholic liver disease, Liver fibrosis, Prognostic marker