Systematic Review with Meta-Analysis: Diagnostic Accuracy of Pro-C3 for Hepatic Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease

Mak, Anne Linde; Lee, Jenny; van Dijk, Anne-Marieke; Vali, Yasaman; Aithal, Guruprasad P.; Schattenberg, Jörn M.; Anstee, Quentin M.; Brosnan, M. Julia; Zafarmand, Mohammad Hadi; Ramsoekh, Dewkoemar; Harrison, Stephen A.; Nieuwdorp, Max; Bossuyt, Patrick M.; Holleboom, Adriaan G.

Abstract

The prevalence and severity of non-alcoholic fatty liver disease (NAFLD) is increasing, yet adequately validated tests for care paths are limited and non-invasive markers of disease progression are urgently needed. The aim of this work was to summarize the performance of Pro-C3, a biomarker of active fibrogenesis, in detecting significant fibrosis (F ≥ 2), advanced fibrosis (F ≥ 3), cirrhosis (F4) and non-alcoholic steatohepatitis (NASH) in patients with NAFLD. A sensitive search of five databases was performed in July 2021. Studies reporting Pro-C3 measurements and liver histology in adults with NAFLD without co-existing liver diseases were eligible. Meta-analysis was conducted by applying a bivariate random effects model to produce summary estimates of Pro-C3 accuracy. From 35 evaluated reports, eight studies met our inclusion criteria; 1568 patients were included in our meta-analysis of significant fibrosis and 2058 in that of advanced fibrosis. The area under the summary curve was 0.81 (95% CI 0.77–0.84) in detecting significant fibrosis and 0.79 (95% CI 0.73–0.82) for advanced fibrosis. Our results support Pro-C3 as an important candidate biomarker for non-invasive assessment of liver fibrosis in NAFLD. Further direct comparisons with currently recommended non-invasive tests will demonstrate whether Pro-C3 panels can outperform these tests, and improve care paths for patients with NAFLD.

Citation

Mak, A. L., Lee, J., van Dijk, A.-M., Vali, Y., Aithal, G. P., Schattenberg, J. M., Anstee, Q. M., Brosnan, M. J., Zafarmand, M. H., Ramsoekh, D., Harrison, S. A., Nieuwdorp, M., Bossuyt, P. M., & Holleboom, A. G. (2021). Systematic Review with Meta-Analysis: Diagnostic Accuracy of Pro-C3 for Hepatic Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease. Biomedicines, 9(12), Article 1920. https://doi.org/10.3390/biomedicines9121920

• Journal Article Type: Article
• Acceptance Date: Dec 10, 2021
• Online Publication Date: Dec 15, 2021
• Publication Date: Dec 15, 2021
• Deposit Date: Jan 4, 2022
• Publicly Available Date: Jan 6, 2022
• Journal: Biomedicines
• Electronic ISSN: 2227-9059
• Publisher: MDPI
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Issue: 12
• Article Number: 1920
• DOI: https://doi.org/10.3390/biomedicines9121920
• Keywords: General Biochemistry, Genetics and Molecular Biology; Medicine (miscellaneous)
• Public URL: https://nottingham-repository.worktribe.com/output/7163593
• Publisher URL: https://www.mdpi.com/2227-9059/9/12/1920