Interleukin-2 receptor alpha as a biomarker for nonalcoholic fatty liver disease diagnosis

Wei-Yu Kao; Yuan-Feng Lin; I-Wei Chang; Chi-Long Chen; Jui-Hsiang Tang; Chun-Chao Chang; Yu-Jia Chang; Weu Wang

doi:10.1097/JCMA.0000000000000469

Interleukin-2 receptor alpha as a biomarker for nonalcoholic fatty liver disease diagnosis

J Chin Med Assoc. 2021 Mar 1;84(3):261-266. doi: 10.1097/JCMA.0000000000000469.

Authors

Wei-Yu Kao^{1

2

3}, Yuan-Feng Lin¹, I-Wei Chang^{4

5

6

7}, Chi-Long Chen^{4

6}, Jui-Hsiang Tang^{2

3}, Chun-Chao Chang^{1

2

3}, Yu-Jia Chang¹, Weu Wang^{8

9}

Affiliations

¹ Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.
² Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC.
³ Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.
⁴ Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.
⁵ Department of Clinical Pathology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC.
⁶ Department of Pathology, Taipei Medical University Hospital, Taipei, Taiwan, ROC.
⁷ Department of Pathology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, ROC.
⁸ Division of Digestive Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan, ROC.
⁹ Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.

PMID: 33306598
DOI: 10.1097/JCMA.0000000000000469

Abstract

Background: Two recent studies in the adult and pediatric Nonalcoholic Steatohepatitis-Clinical Research Network (NASH-CRN) cohorts have shown that soluble interleukin-2 receptor alpha (IL2RA) levels increased with fibrosis severity. However, no hepatic study has been conducted in Asian morbidly obese patients who underwent bariatric surgery. In this study, we proposed IL2RA as a biomarker for nonalcoholic fatty liver disease (NAFLD) diagnosis and performed immunohistochemistry (IHC) staining of IL2RA.

Methods: This prospective cohort study enrolled 123 morbidly obese patients who underwent bariatric surgery at Taipei Medical University Hospital from October 2016 to June 2018. During bariatric surgery, all patients underwent a wedge liver biopsy under laparoscopic guidance. The diagnoses of NASH and liver fibrosis were made histologically. In IHC of IL2RA, the number of lymphocytes with IL2RA immunoreactivity was counted in five high-power fields (×400, total: 1.19 mm2).

Results: Among the 123 patients, the mean age was 35.5 years, mean body mass index (BMI) was 40.6 kg/m2, 87 (70.7%) were female, 25 (20.7%) had diabetes mellitus, and 57 (46.3%; 11 with non-NAFLD and 46 with steatosis) and 66 (53.7%) were included in the non-NASH and NASH groups, respectively. The NASH group had higher IHC of IL2RA than the non-NASH group. In multivariate analysis, IHC of IL2RA (odds ratio, 1.025; 95% confidence interval, 1.006-1.045; p = 0.011) and alanine aminotransferase (ALT; odds ratio, 1.045; 95% confidence interval, 1.018-1.073; p = 0.001) were the independent factors associated with NASH. The area under the receiver operating curve of IL2RA IHC for NASH was 0.627 at the cutoff value of 82 (p = 0.0113).

Conclusion: IL2RA is significantly associated with NASH in morbidly obese patients and would be a useful biomarker for NASH diagnosis.

Trial registration: ClinicalTrials.gov NCT04059029.

MeSH terms

Adult
Bariatric Surgery
Biomarkers*
Female
Humans
Interleukin-2 Receptor alpha Subunit / blood*
Male
Non-alcoholic Fatty Liver Disease / diagnosis*
Prospective Studies

Substances

Biomarkers
Interleukin-2 Receptor alpha Subunit

Associated data

ClinicalTrials.gov/NCT04059029