Premium
Identification of clinical risk factors for histological progression of primary biliary cholangitis
Author(s) -
Fujinaga Yukihisa,
Namisaki Tadashi,
Moriya Kei,
Kitade Mitsuteru,
Kawaratani Hideto,
Shimozato Naotaka,
Kaji Kosuke,
Takaya Hiroaki,
Sawada Yasuhiko,
Seki Kenichiro,
Akahane Takemi,
Okura Yasushi,
Sato Shinya,
Saikawa Soichiro,
Nakanishi Keisuke,
Kubo Takuya,
Furukawa Masanori,
Kitagawa Koh,
Ozutsumi Takahiro,
Tsuji Yuki,
Kaya Daisuke,
Mashitani Tsuyoshi,
Ishida Koji,
Ogawa Hiroyuki,
Takagi Hirotetsu,
Noguchi Ryuichi,
Mitoro Akira,
Yamao Junichi,
Yoshiji Hitoshi
Publication year - 2019
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13355
Subject(s) - ursodeoxycholic acid , gastroenterology , medicine , fibrosis , univariate analysis , primary sclerosing cholangitis , logistic regression , gamma glutamyltransferase , hepatic fibrosis , multivariate analysis , disease , biology , biochemistry , enzyme
Aim To identify laboratory predictors of histological progression (HP) of primary biliary cholangitis (PBC). Methods Sequential biopsies were carried out on 35 (11.4%) of 308 patients with PBC treated with ursodeoxycholic acid (UDCA). Patients were divided into high γ‐glutamyl transpeptidase (GGT) ( n = 18) and low GGT ( n = 17) groups, based on the median value of GGT at baseline. Patients were then categorized as showing HP (progressive group, PG) or lacking HP (non‐progressive group, NPG) according to the Scheuer and Nakanuma classifications, with the latter grading liver fibrosis (fibrosis score) and bile duct loss (BDL score). Results According to the Scheuer definition, 12 patients had HP and 23 did not. According to the Nakanuma definition, 8 and 27 patients were in the PG and NPG groups, respectively. The fibrosis and BDL scores progressed in 13 and 8 patients, respectively, whereas 22 and 25 patients did not show HP, respectively. Fisher's exact probability test analysis revealed that the rate of HP using the Nakanuma fibrosis score was significantly higher in the high GGT group compared to the low GGT group ( P < 0.05). However, no significant correlation was found between the HP of PBC and the biochemical response to UDCA therapy. Both univariate and multivariate logistic regression analyses indicated that the serum GGT level at baseline is an independent risk factor for an increased Nakanuma fibrosis score. Conclusions The level of serum GGT at baseline is significantly associated with liver fibrosis progression in PBC, and therefore could help to predict the HP of PBC.