Liver Fatty Acid Binding Protein: Is it an early diagnostic and prognostic marker in liver damage?

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Pinar Gokcen
Erol Cakmak
Gupse Adali
Halef Okan Dogan
Seyma Nur Yildiz
Oguzhan Ozturk
Hamdi Levent Doganay
Kamil Ozdil

Abstract

Objective: The majority of the liver function tests are not specific to the liver. The histological liver damage begins before patients are diagnosed with cirrhosis and continues afterwards. Therefore, there is an increasing demand for early and specific markers that are correlated with liver damage. This study aims to investigate if serum and urinary liver fatty acid-binding protein (L-FABP) levels could be used as an early diagnostic marker of liver cirrhosis.


Material and Methods: This cross-sectional study included 30 patients with compensated liver cirrhosis, 27 patients with decompensated liver cirrhosis, and 30 healthy controls. The patients and healthy controls were tested for serum and urinary L-FABP levels.


Results: The serum and urinary L-FABP levels were higher in patients with cirrhosis than the healthy controls (both p<0.001). The cut-off value of serum and urinary L-FABP was computed as 721.78 ng/ml and 621.25 ng/ml, respectively. The sensitivity of serum and urinary L-FABP to detect cirrhosis at this cut-off was 99.8% and 98.9%. The specificity, positive predictive value, and negative predictive value of serum and urinary L-FABP at these cut-off levels were 100 %. There was no difference in terms of serum and urinary L-FABP between compensated and decompensated cirrhosis patients. Accordingly, no correlation was determined between serum/urinary L-FABP levels and cirrhosis complications.


Conclusion: L-FABP increases in serum and urine in response to hepatocyte damage that can result in liver fibrosis. We demonstrated that patients with liver cirrhosis had high L-FABP levels. L-FABP may be used as a predictive non-invasive marker of cirrhosis as it can be detected before the clinical symptoms of liver damage.

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How to Cite
Gokcen, P., Cakmak, E., Adali, G., Dogan, H. O., Yildiz, S. N., Ozturk, O., Doganay, H. L., & Ozdil, K. (2021). Liver Fatty Acid Binding Protein: Is it an early diagnostic and prognostic marker in liver damage?. Medical Science and Discovery, 8(4), 213–218. https://doi.org/10.36472/msd.v8i4.516
Section
Research Article
Received 2021-03-22
Accepted 2021-04-12
Published 2021-04-15

References

Byass P. The global burden of liver disease: a challenge for methods and public health. BMC Med. 2014;12(1):159. doi: 10.1186/s12916-014-0159-5.

Scaglione S, Kliethermes S, Cao G, Shoham D, Durazo R, Luke A, et al. The epidemiology of cirrhosis in the United States: a population-based study. J Clin Gastroenterol. 2015;49(8):690–6. doi: 10.1097/MCG.0000000000000208.

Marcellin P, Kutala BK. Liver diseases: a major, neglected global public health problem requiring urgent actions and large-scale screening. Liver Int. 2018;38(1):2–6. doi: 10.1111/liv.13682.

Sharma S, Khalili K, Nguyen GC. Non-invasive diagnosis of advanced fibrosis and cirrhosis. World J Gastroenterol. 2014;20(45):16820-30. doi: 10.3748/wjg.v20.i45.16820.

Kanda T, Fujii H, Tani T, Murakami H, Suda T, Sakai Y, et al. Intestinal fatty acid-binding protein is a useful diagnostic marker for mesenteric infarction in humans. Gastroenterology. 1996;110(2):339-43. doi: 10.1053/gast.1996.v110.pm8566578.

Furuhashi M, Hotamisligil GS. Fatty acid-binding proteins: role in metabolic diseases and potential as drug targets. Nat Rev Drug Discov. 2008;7(6):489-503. doi: 10.1038/nrd2589.

Wang J, Wei Y, Wang D, Chan LL, Dai J. Proteomic study of the effects of complex environmental stresses in the livers of goldfish (Carassius auratus) that inhabit Gaobeidian Lake in Beijing, China. Ecotoxicology. 2008;17(3):213-20. doi: 10.1007/s10646-007-0187-4.

Kim H, Gil G, Lee S, Kwak A, Jo S, Kim E, et al. Cytokine-like Activity of Liver Type Fatty Acid Binding Protein (L-FABP) Inducing Inflammatory Cytokine Interleukin-6. Immune Netw. 2016;16(5):296-304. doi: 10.4110/in.2016.16.5.296.

Kamijo A, Sugaya T, Hikawa A, Okada M, Okumura F, Yamanouchi M, et al. Urinary excretion of fatty acid-binding protein reflects stress overload on the proximal tubules. Am J Pathol. 2004;165(4):1243–55. doi: 10.1016/S0002-9440(10)63384-6.

Yamamoto T, Noiri E, Ono Y, Doi K, Negishi K, Kamijo A, et al. Renal L-type fatty acid--binding protein in acute ischemic injury. J Am Soc Nephrol. 2007;18(11):2894-902. doi: 10.1681/ASN.2007010097.

Matsui K, Kamijo-Ikemori A, Imai N, Sugaya T, Yasuda T, Tatsunami S, et al. Clinical significance of urinary liver-type fatty acid-binding protein as a predictor of ESRD and CVD in patients with CKD. Clin Exp Nephrol. 2016;20(2):195-203. doi: 10.1007/s10157-015-1144-9.

Smathers RL, Petersen DR. The human fatty acid-binding protein family: evolutionary divergences and functions. Hum Genomics. 2011;5(3):170–91. doi: 10.1186/1479-7364-5-3-170.

Pelsers MM, Namiot Z, Kisielewski W, Namiot A, Januszkiewicz M, Hermens WT, et al. Intestinal-type and liver-type fatty acid-binding protein in the intestine. Tissue distribution and clinical utility. Clin Biochem. 2003;36(7):529–35. doi: 10.1016/s0009-9120(03)00096-1.

Karvellas CJ, Speiser JL, Tremblay M, Lee WM, Rose CF. Elevated FABP1 serum levels are associated with poorer survival in acetaminophen-induced acute liver failure. Hepatology. 2017;65(3):938–49. doi: 10.1002/hep.28945.

Pelsers MM, Morovat A, Alexander GJ, Hermens WT, Trull AK, Glatz JF. Liver fatty acid-binding protein as a sensitive serum marker of acute hepatocellular damage in liver transplant recipients. Clin Chem. 2002;48(11):2055–7. PMID: 12406996.

Monbaliu D, de Vries B, Crabbé T, van Heurn E, Verwaest C, Roskams T, et al. Liver fatty acid-binding protein: An early and sensitive plasma marker of hepatocellular damage and a reliable predictor of graft viability after liver transplantation from non-heart-beating donors. Transplant Proc. 2005;37(1):413-6. doi: 10.1016/j.transproceed.2004.12.103.

Cakir OO, Toker A, Ataseven H, Demir A, Polat H. The importance of liver-fatty acid-binding protein in the diagnosis of liver damage in patients with acute hepatitis. J Clin Diagn Res. 2017;11(4):17-21. doi: 10.7860/JCDR/2017/24958.9621.

Parés A, Deulofeu R, Giménez A, Caballería L, Bruguera M, Caballería J, et al. Serum hyaluronate reflects hepatic fibrogenesis in alcoholic liver disease and is useful as a marker of fibrosis. Hepatology. 1996;24(6):1399-1403. doi: 10.1002/hep.510240615.

Zhu CL, Li WT, Li Y, Gao RT. Serum levels of tissue inhibitör of metalloproteinase-1 are correlated with liver fibrosis in patients with chronic hepatitis B. J Dig Dis. 2012;13(11):558-63. doi: 10.1111/j.1751-2980.2012.00629.x.

Lee MH, Cheong JY, Um SH, Seo YS, Kim DJ, Hwang SG, et al. Comparison of surrogate serum markers and transient elastography (Fibroscan) for assessing cirrhosis in patients with chronic viral hepatitis. Dig Dis Sci. 2010;55(12):3552-60. doi: 10.1007/s10620-010-1219-0.

Saitou Y, Shiraki K, Yamanaka Y, Yamaguchi Y, Kawakita T, Yamamoto N, et al. Noninvasive estimation of liver fibrosis and response to interferon therapy by a serum fibrogenesis marker, YKL-40, in patients with HCV-associated liver disease. World J Gastroenterol. 2005;11(4):476-81. doi: 10.3748/wjg.v11.i4.476.

Adida A, Spener F. Intracellular lipid-binding proteins and nuclear receptors involved in branched-chain fatty acid signaling. Prostaglandins Leukot Essent Fatty Acids. 2002;67(2-3):91-8. doi: 10.1054/plef.2002.0404.

Desvergne B, Wahli W. Peroxisome proliferator-activated receptors: nuclear control of metabolism. Endocr Rev. 1999;20(1-2):649-88. doi: 10.1210/edrv.20.5.0380.

Ozenirler S, Degertekin CK, Erkan G, Elbeğ Ş, Tuncer C, Kandilc U, et al. Serum liver fatty acid-binding protein shows good correlation with liver histology in NASH. Hepatogastroenterology. 2013;60(125):1095-100. doi: 10.5754/hge11949.

Suzuki G, Ichibayashi R, Yamamoto S, Nakamichi Y, Watanabe M, Honda M. Clinical significance of urinary L-FABP in the emergency department. Int J Emerg Med. 2019;12(1):24. doi: 10.1186/s12245-019-0244-9.

Yap DY, Seto WK, Fung J, Chok SH, Chan SC, Chan GC, et al. Serum and urinary biomarkers that predict hepatorenal syndrome in patients with advanced cirrhosis. Dig Liver Dis. 2017;49(2):202-6. doi: 10.1016/j.dld.2016.11.001.