Relationship between serum hyaluronic acid level and stage of liver fibrosis in patients with chronic hepatitis [Odnos izmedu koncentracije hijaluronske kiseline u serumu i stadija jetrene fibroze kod bolesnika s kronicnim hepatitisom]

Abstract

Background: Liver biopsy is the gold standard for assessing liver disease stage, but It is prone to some complications. Noninvasive methods have been proposed as surrogate markers for liver biopsy. Serum hyaluronic acid (HA) level has been shown to increase with the development of liver fibrosis. The aim of this study was to determine differences in HA concentration between patients with liver fibrosis and healthy individuals without any signs of liver disease, and the optimal cut-off value for discrimination between the two study groups of Iranian population. Materials and methods: Serum HA levels in chronic hepatitis patients (N = 62) and controls (N = 20) were compared by ELISA, while the stage of fibrosis was assessed by the modified Knodell score. Results: The mean serum HA concentrations was higher in patients (113.4 آ± 59.2 ng/mL) than in the control group (46.0 آ± 10.5 ng/mL; P < 0.001). Patients with higher stages and grades of liver necroinfiammatory injuries had higher serum HA concentrations. Differences in serum HA concentrations were statistically significant in all fibrosis stages as compared to healthy controls (P < 0.05). The cut-off point of serum HA concentration identified (59.5 ng/mL) showed a reasonably good sensitivity (82.3%) and specificity (85%). Conclusions: There was a strong correlation between serum HA concentration and the grade of liver necroinfiammatory injury. Our findings suggested serum HA concentration increases above the predictive value to be associated with liver fibrosis and could be used as a noninvasive marker to discriminate between patients with liver fibrosis and healthy individuals.