caa a22 4500 44579450X CHVBK 20180317145120.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10620-011-1771-2 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1771-2 Serum Immunoglobulin A Concentration Is an Independent Predictor of Liver Fibrosis in Nonalcoholic Steatohepatitis Before the Cirrhotic Stage [Elektronische Daten] [Kengo Tomita, Toshiaki Teratani, Hirokazu Yokoyama, Takahiro Suzuki, Rie Irie, Hirotoshi Ebinuma, Hidetsugu Saito, Ryota Hokari, Soichiro Miura, Toshifumi Hibi] Background and Aims: The similarity of alcoholic liver disease and nonalcoholic steatohepatitis (NASH) in terms of pathogenic mechanisms suggests that immunoglobulin A (IgA) may play an important role in the pathogenesis of NASH. We aimed to determine whether serum IgA concentrations allow a diagnosis of liver fibrosis in NASH. Methods: We compared serum IgA concentrations between 108 patients with stages 0-2 NASH and 19 patients with stage 3 NASH. Results: In a univariate analysis, age (P<0.0001), gender (P=0.0039), serum albumin level (P=0.0192), AST (P<0.0001), AST/ALT ratio (P<0.0001), platelet count (P=0.0027), hyaluronic acid level (P<0.0001), fasting blood sugar (FBS) (P=0.0013), IRI (P=0.0001), prothrombin time (%) (P=0.0287), IgA (P<0.0001), total sum of IgG, IgA, and IgM (P=0.0049), and IgA/(IgG+IgA+IgM) (P=0.0105) were significantly elevated in severe-stage NASH patients compared with the early-stage NASH group. Multiple logistic regression analysis showed that in severe-stage NASH patients, only serum IgA concentrations were significantly elevated (P=0.0225) relative to early-stage NASH patients. The area under the curve (AUC) of serum IgA concentrations was 0.758 for detecting severe-stage NASH compared with early-stage NASH. Conclusions: Serum IgA concentration could be a useful independent predictor for assessing the pre-cirrhotic progression of NASH. Springer Science+Business Media, LLC, 2011 Diagnosis nationallicence Immunoglobulin A nationallicence Liver fibrosis nationallicence Nonalcoholic steatohepatitis nationallicence NAFLD : Nonalcoholic fatty liver disease nationallicence NASH : Nonalcoholic steatohepatitis nationallicence IgA : Immunoglobulin A nationallicence ALD : Alcoholic liver disease nationallicence SD : Standard deviation nationallicence ANOVA : Analysis of variance nationallicence ROC : Receiver operating characteristic nationallicence BMI : Body mass index nationallicence FBS : Fasting blood sugar nationallicence AUC : Area under the curve nationallicence IRI : Immunoreactive insulin nationallicence AUC : Area under the curve nationallicence PPV : Positive predictive value nationallicence NPV : Negative predictive value nationallicence Tomita Kengo Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut Teratani Toshiaki Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut Yokoyama Hirokazu Health Center, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut Suzuki Takahiro Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut Irie Rie Department of Pathology, Kawasaki Municipal Hospital, 12-1 Shinkawadori, 210-0013, Kawasaki-ku, Kawasaki-shi, Kanagawa, Japan aut Ebinuma Hirotoshi Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut Saito Hidetsugu Graduate School of Pharmaceutical Sciences, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, 105-8512, Minato-ku, Tokyo, Japan aut Hokari Ryota Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, 359-8513, Tokorozawa-shi, Saitama, Japan aut Miura Soichiro Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, 359-8513, Tokorozawa-shi, Saitama, Japan aut Hibi Toshifumi Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3648-3654 0163-2116 56:12<3648 2011 56 10620 https://doi.org/10.1007/s10620-011-1771-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1771-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tomita Kengo Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut NATIONALLICENCE 700 1- Teratani Toshiaki Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut NATIONALLICENCE 700 1- Yokoyama Hirokazu Health Center, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut NATIONALLICENCE 700 1- Suzuki Takahiro Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut NATIONALLICENCE 700 1- Irie Rie Department of Pathology, Kawasaki Municipal Hospital, 12-1 Shinkawadori, 210-0013, Kawasaki-ku, Kawasaki-shi, Kanagawa, Japan aut NATIONALLICENCE 700 1- Ebinuma Hirotoshi Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut NATIONALLICENCE 700 1- Saito Hidetsugu Graduate School of Pharmaceutical Sciences, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, 105-8512, Minato-ku, Tokyo, Japan aut NATIONALLICENCE 700 1- Hokari Ryota Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, 359-8513, Tokorozawa-shi, Saitama, Japan aut NATIONALLICENCE 700 1- Miura Soichiro Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, 359-8513, Tokorozawa-shi, Saitama, Japan aut NATIONALLICENCE 700 1- Hibi Toshifumi Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3648-3654 0163-2116 56:12<3648 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer