High biological variation of serum hyaluronic acid and hepascore, a biochemical marker model for the prediction of liver fibrosis

  • Rossi E
  • Adams L
  • Ching H
 et al. 
  • 6

    Readers

    Mendeley users who have this article in their library.
  • 12

    Citations

    Citations of this article.

Abstract

BACKGROUND: Serum hyaluronic acid and biochemical models which require hyaluronic acid analysis are commonly used as predictors of liver fibrosis in patients with chronic liver disease, however biological variation data for hyaluronic acid are deficient. METHODS: Four serial serum samples were obtained at weekly intervals from healthy volunteers and patients with chronic hepatitis B, chronic hepatitis C and non- alcoholic fatty liver disease (NAFLD; 20 in each group). The within-individual week-to-week variation (CVI) and reference change values for hyaluronic acid, alpha(2)-macroglobulin and Hepascore were obtained. Hepascore is calculated from hyaluronic acid, alpha2-macroglobulin, bilirubin and gamma-glutamyltransferase activity. RESULTS: Hyaluronic acid displayed large within-individual variation, the CVI values were 62% in healthy subjects, 38% in hepatitis C, 37% in hepatitis B and 36% in NAFLD patients. Hepascore CVIs were 43% in healthy subjects, 24% in hepatitis C, 28% in hepatitis B and 39% in NAFLD patients. alpha(2)-Macroglobulin was much less variable with CVIs ranging from 4.4% to 7.6%. Bland-Altman plots of week-to-week variations showed rates of significant disagreement for samples collected in any 2 successive weeks varied from 5% in NAFLD patients to 8.3% in healthy subjects. CONCLUSIONS: When using non-fasting serum samples, hyaluronic acid and to a lesser extent, the Hepascore model display large within-individual variations in both health and chronic liver disease. This information is critical for interpreting the significance of both single measurements and changes in serial measurements.

Author-supplied keywords

  • Hepascore
  • Hyaluronic acid
  • Liver fibrosis
  • Reference change value
  • Within-individual variation

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document

Authors

  • Enrico Rossi

  • Helena L. Ching

  • Max Bulsara

  • Gerry C. MacQuillan

  • Gary P. Jeffrey

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free