Prediction of liver fibrosis severity in alcoholic liver disease by human microfibrillar‐associated protein 4

Background
Alcoholic liver disease (ALD) is a public health concern that is the cause of half of all cirrhosis‐related deaths. Early detection of fibrosis, ideally in the pre‐cirrhotic stage, is a key strategy for improving ALD outcomes and for preventing progression to cirrhosis. Previous studies identified the blood‐borne marker human microfibrillar‐associated protein 4 (MFAP4) as a biomarker for detection of hepatitis C virus‐related fibrosis..

..MFAP4 was present in fibrotic hepatic tissue and serum MFAP4 levels increased with fibrosis grade. The area under the receiver operating characteristic curve (AUROC) for detection of cirrhosis was 0.91 (95% CI 0.85‐0.96) in the training cohort and 0.91 (95% CI 0.79‐1.00) in the validation cohort. For detection of advanced fibrosis, the AUROC was 0.88 (95% CI 0.81‐0.94) in the training cohort and 0.92 (95% CI 0.83‐1.00) in the validation cohort. The diagnostic accuracy did not differ between MFAP4 and the enhanced liver fibrosis (ELF) test or transient elastography (TE) in an intention‐to‐diagnose analysis. MFAP4 did not predict hepatic decompensation in a time‐to‐decompensation analysis in a subgroup of patients with cirrhosis.

Conclusion
MFAP4 is a novel biomarker that can detect ALD‐related fibrosis with high accuracy

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