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. 2020 Aug;34(8):e23316.
doi: 10.1002/jcla.23316. Epub 2020 Mar 29.

Diagnostic performance of Mac-2 binding protein glycosylation isomer (M2BPGi) in screening liver fibrosis in health checkups

Affiliations

Diagnostic performance of Mac-2 binding protein glycosylation isomer (M2BPGi) in screening liver fibrosis in health checkups

Eun-Hee Nah et al. J Clin Lab Anal. 2020 Aug.

Abstract

Background: Mild-to-moderate fibrosis is rarely diagnosed because the disease is asymptomatic in the early stage. The serum level of Mac-2 binding protein glycosylation isomer (M2BPGi) has been found to increase with the severity of liver fibrosis. The aim of this study was to determine the diagnostic performance of M2BPGi in screening liver fibrosis using magnetic resonance elastography (MRE) as a reference standard and to compare it with using the aspartate aminotransferase-to-platelet ratio (APRI) and the Fibrosis-4 index (FIB-4) in health checkups.

Methods: This cross-sectional study consecutively selected subjects at health examinations who underwent MRE and M2BPGi testing at eight health promotion centers in Korea between January and September 2019. The serum M2BPGi level was measured using the chemiluminescence enzyme immunoassay method. The measured levels were indexed using the cutoff index (COI). COI values of M2BPGi were compared with the MRE results.

Results: The median (interquartile) values of COI for fibrosis stages F0 (normal liver stiffness), F1 (mild fibrosis), F2 (significant fibrosis), and ≥F3 (advanced fibrosis) were 0.49 (0.34-0.61), 0.48 (0.38-0.68), 0.64 (0.43-1.03), and 1.01 (0.75-1.77), respectively (P < .0001). The AUCs of the COI for the screening of fibrosis stage ≥F1, ≥F2, and ≥F3 were 0.591, 0.698, and 0.853, respectively. Using a threshold of 0.75 for COI to exclude advanced fibrosis had a sensitivity, specificity, and negative predictive value of 80.0%, 77.9%, and 98.9%, respectively. The AUC for excluding advanced fibrosis was better for M2BPGi than for FIB-4 and APRI.

Conclusion: Serum M2BPGi was useful for screening significant and advanced fibrosis in health checkups.

Keywords: M2BPGi; Mac-2 binding protein glycosylation isomer; aspartate aminotransferase-to-platelet ratio; fibrosis-4 index; liver fibrosis; magnetic resonance elastography.

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Figures

Figure 1
Figure 1
Box plots of Mac‐2 binding protein glycosylation isomer (M2BPGi) cutoff index (COI) according to liver fibrosis
Figure 2
Figure 2
Analysis of areas under the receiver operating characteristic curves (AUCs) for the diagnostic ability of the M2BPGi test for liver fibrosis
Figure 3
Figure 3
Comparison of M2BPGi with Fibrosis‐4 index (FIB‐4) and aspartate aminotransferase‐to‐platelet ratio index (APRI) for diagnosing liver fibrosis

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