Clinical implications of serum Mac-2-binding protein (M2BPGi) as novel biomarkers of advanced hepatic fibrosis in diabetes
Background Appropriate strategy for screening, identification, and linkage to care of patients with advanced fibrosis in general population is unsolved issue. The aim of this study was to find reference value and clinical role of Mac2 binding protein glycan isomer (M2BPGi) in health check-up setting.
Methods Adult subjects (n=1,073) who underwent a health check-up at the healthcare center were finally included for analysis, except for 952 subjects with risk factors for liver disease and insufficient data. Body composition analyzed by using the Bioelectrical Impedance Analysis (BIA). M2BPGi quantification based on a lectin antibody sandwich immunoassay. Fatty liver diagnosed by using abdominal sonography.
Results Reference value of M2BPGi was 0.5~1.0 C.O.I in the average risk group. Serum M2BPGi showed a positive correlation with metabolic parameters as well as age. Prevalence of abnormal M2BPGi (> 1.0) was higher in low muscle mass (4.7%, vs 17.4%, p=0.002), metabolic syndrome (14.2% vs. 30.4%, p=0.003) and hypertension (21.8%, vs. 58.7%, p<0.001) compare to healthy control. M2BPGi had a positive correlation with estimated fibrosis formulae such as FIB-4 (R=0.293, p< 0.001) and NAFLD fibrosis score (R=0.248, p<0.001). While the prevalence of advanced fibrosis in total population was just 1.6% (FIB-4 >2.65), the prevalence of advanced fibrosis increased to 50% in high M2BPGi (> 1.0) group with diabetes. It was 31.25 times higher than total population group.
Conclusions There was high possibility of advanced hepatic fibrosis in subjects with abnormal M2BPGi levels (> 1.0) in diabetes.
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