Serum Wisteria floribunda agglutinin‐positive Mac‐2‐binding protein expression predicts disease severity in nonalcoholic steatohepatitis patients

Abstract

Abstract The role of Wisteria floribunda agglutinin‐positive Mac‐2 binding protein (WFA+‐M2BP) in the prediction of disease severity in nonalcoholic fatty liver disease (NAFLD) remains elusive. This study evaluated the performance of WFA+‐M2BP in predicting fibrosis in patients with NAFLD. A total of 80 patients with biopsy‐proven nonalcoholic steatohepatitis (NASH) were enrolled. Serum WFA+‐M2BP levels were measured using standard methods. The fibrosis‐4 (FIB‐4) index was also measured. The mean values of WFA+‐M2BP were 1.0, 1.0, 0.8, and 2.2 in Metavir fibrosis stage F0, F1, F2, and F3‐4, respectively (linear trend p = 0.005). The optimal cut‐off value of WFA+‐M2BP in predicting advanced fibrosis (F3‐4) was 1.37 cut‐off index (COI), yielding the sensitivity, specificity, positive predictive value (PPV), negative predictive value, and accuracy of 75.0, 79.4, 39.1, 94.7, and 78.7%, respectively (p < 0.001). Combining WFA+‐M2BP with FIB‐4 significantly increased the diagnostic performance for advanced fibrosis, yielding specificity, PPV, and accuracy of 100, 100, and 93%, respectively. The significant factors predicting advanced liver fibrosis in the multivariate regression analysis were WFA+‐M2BP ≥ 1.37 COI (OR/confidence interval [CI]: 9.49/1.63–55.21, p = 0.01) and FIB‐4 ≥ 2.80 (OR/CI: 38.18/4.89–297.93, p = 0.001). Monitoring WFA+‐M2BP is suitable for noninvasive assessment of liver fibrosis in NASH patients, particularly in combination with FIB‐4.

Keywords

• FIB‐4
• liver fibrosis
• NASH
• WFA+‐M2BP