Association of alpha-fetoprotein levels with liver stiffness measurement in outpatients with chronic hepatitis B
Juan Wang 1 , Pengpeng Zhang 2 , Juan Liao 1 , Yan Zhu 1 , Xiaoli Liu 3 , Hong Tang 1
Affiliations
Affiliations
1
West China Hospital of Sichuan University, Chengdu, China.
2
The Third Xiangya Hospital, Central South University, Changsha, China.
3
Hunan Provincial Corps Hospital, Chinese People's Armed Police Forces, Changsha, China.
PMID: 33289529 DOI: 10.1042/BSR20203048
Free article
Abstract
The association between alpha-fetoprotein (AFP) levels with the assessment of liver stiffness (LS) in chronic hepatitis B (CHB) patients were explored. A total of 283 outpatients with CHB were enrolled. Patient age, alanine aminotransferase (ALT), aspartate aminotransferase (AST), AFP, platelet (PLT), total bilirubin, direct bilirubin, alkaline phosphatase, albumin, globulin, and albumin/globulin (A/G) levels were associated with LS values in the univariate model (p<0.05). Significant associations between AFP and PLT levels with LS values were observed when both variables were included in the multivariate analysis models. Receiver operation characteristic (ROC) analysis indicated that the combination of AFP and PLT levels could enhance the predictive performance of liver fibrosis (AUC=0.819, p<0.001) and that PLT levels (PLT<100×10^9/L) combined with high AFP levels (AFP>8 ng/mL) significantly increased the prediction of liver fibrosis (OR=11.216). More importantly, LS values of associated with higher AFP levels (AFP >8 ng/mL), independently of higher ALT or AST values, were significantly higher than those of low AFP level groups. In conclusion, in Chinese outpatients with CHB, AFP outperformed ALT and/or AST levels in terms of their association with LS. AFP and PLT levels were independently associated with LS, and their combined assessment could enhance the diagnostic and predictive performance of liver fibrosis among CHB patients.