Association of Mac-2-binding protein glycosylation isomer level with nutritional status in chronic liver disease

Yuji Eso; Atsushi Takai; Kojiro Taura; Ken Takahashi; Yoshihide Ueda; Hiroyuki Marusawa; Hiroshi Seno

doi:10.1111/jgh.14130

Association of Mac-2-binding protein glycosylation isomer level with nutritional status in chronic liver disease

J Gastroenterol Hepatol. 2018 Feb 22. doi: 10.1111/jgh.14130. Online ahead of print.

Authors

Yuji Eso¹, Atsushi Takai¹, Kojiro Taura², Ken Takahashi¹, Yoshihide Ueda¹, Hiroyuki Marusawa¹, Hiroshi Seno¹

Affiliations

¹ Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
² Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

PMID: 29473206
DOI: 10.1111/jgh.14130

Abstract

Background and aim: Mac-2-binding protein glycosylation isomer (M2BPGi) was recently identified as a serum glycobiomarker for liver fibrosis. However, the relationship between M2BPGi and malnutrition in patients with chronic liver disease (CLD) is unknown. We aimed to evaluate whether M2BPGi could be a surrogate marker for malnutrition in patients with CLD.

Methods: In total, 338 outpatients with CLD were enrolled (median age: 67 years). We evaluated the associations among liver fibrosis markers (M2BPGi, fibrosis-4 index, and aspartate aminotransferase-to-platelet count ratio index), Child-Pugh stages, and nutritional status markers.

Results: The median value (range) of serum M2BPGi levels was 0.94 cut-off index (COI) (0.22-11.57) in chronic hepatitis and Child-Pugh A (n = 274), 4.775 COI (1.32-16.68) in Child-Pugh B (n = 46), and 11.37 COI (6.03-18.33) in Child-Pugh C (n = 18) (overall significance, P < 0.001). Serum M2BPGi levels showed a strong correlation with serum albumin concentration and controlling nutritional status score (r_s = -0.649, P < 0.001 and r_s = 0.671, P < 0.001, respectively). The correlations between M2BPGi and nutritional status markers were especially high in patients with hepatitis C virus infection and non-B non-C hepatitis and patients with hepatocellular carcinoma. Among the three fibrosis markers, M2BPGi yielded the highest area under the receiver operating characteristic curve (0.920) for predicting hypoalbuminemia at an optimal cut-off value of 2.41 (sensitivity, 87.3%; specificity, 87.6%; P < 0.001).

Conclusions: Serum M2BPGi levels are correlated with nutritional status markers in patients with CLD and could be a useful clinical marker of malnutrition.

Keywords: Mac-2-binding protein glycosylation isomer; chronic liver disease; liver fibrosis; malnutrition.