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Lookup NU author(s): Professor Stuart McPhersonORCiD, Elsbeth Henderson, Professor Alastair BurtORCiD, Professor Chris Day, Professor Quentin AnsteeORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
Background: A third of the population are estimated to have NAFLD of varying severity. Serum immunoglobulins are frequently elevated in patients with chronic liver disease, but little is known about serum immunoglobulin levels in patients with NAFLD. Aim: To evaluate serum immunoglobulin levels (IgA, IgG and IgM) in a large cohort of patients with biopsy-proven NAFLD and determine if immunoglobulin levels are associated with clinical or histological features. Methods: Patients seen in a tertiary fatty liver clinic between 1999-2009 were included. Liver biopsies were assessed using the Kleiner score. Immunoglobulin levels and other blood tests were taken at time of biopsy. Results: 285 patients (110 simple steatosis and 175 NASH) had serum immunoglobulins measured within 6 months of liver biopsy. 130 (46%) patients had elevated (>1x upper limit of normal) serum IgA levels, 28 (10%) patients had elevated IgG and 22 (8%) raised IgM. Serum IgA levels were elevated more frequently in patients with NASH compared with subjects with simple steatosis (55% vs 31%, p<0.001). Overall, 55 (19%) patients had advanced liver fibrosis (Kleiner stage 3-4). There was a significant positive association between serum IgA levels and the stage of fibrosis (p<0.001). Serum IgA, age, platelets, AST/ALT ratio and BMI were all independently with advanced fibrosis following multivariate analysis. A model constructed from these independent predictors accurately predicted advanced fibrosis (AUROC 0.87). Conclusions: The serum IgA level was frequently elevated in patients with NAFLD and was an independent predictor of advanced fibrosis.
Author(s): McPherson S, Henderson E, Burt AD, Day CP, Anstee QM
Publication type: Article
Publication status: Published
Journal: Journal of Hepatology
Year: 2014
Volume: 60
Issue: 5
Pages: 1055-1062
Print publication date: 01/05/2014
Online publication date: 17/01/2014
Acceptance date: 06/01/2014
Date deposited: 01/03/2015
ISSN (print): 0168-8278
ISSN (electronic): 1600-0641
Publisher: Elsevier BV
URL: http://dx.doi.org/10.1016/j.jhep.2014.01.010
DOI: 10.1016/j.jhep.2014.01.010
PubMed id: 24445215
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