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Article

Efficacy of Serum Ferritin–Zinc Ratio for Predicting Advanced Liver Fibrosis in Patients with Autoimmune Hepatitis

by
Kei Moriya
1,2,*,
Shinya Sato
1,
Norihisa Nishimura
1,
Hideto Kawaratani
1,
Hiroaki Takaya
1,
Kosuke Kaji
1,
Tadashi Namisaki
1,
Masakazu Uejima
1,2,
Shinsaku Nagamatsu
1,2,
Hideki Matsuo
1,2 and
Hitoshi Yoshiji
1
1
Department of Gastroenterology, Nara Medical University, Kashihara 634-8521, Japan
2
Department of Gastroenterology, Nara Prefecture General Medical Center, 897-5, 2-Chome, Shichijo-Nishimachi, Nara 630-8581, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2023, 12(13), 4463; https://doi.org/10.3390/jcm12134463
Submission received: 6 June 2023 / Revised: 29 June 2023 / Accepted: 2 July 2023 / Published: 3 July 2023
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
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Abstract

Background/Aims: The search for noninvasive biomarkers that can efficiently estimate the extent of liver fibrosis progression is ongoing. Although Fibrosis-4 (FIB-4), the aspartate transaminase-to-platelet ratio index (APRI), and the Forns index have been reported as useful biomarkers, their investigation in autoimmune hepatitis (AIH) is limited. This study aimed to examine the usefulness of these serological indices and a newly developed index in predicting liver fibrosis progression in AIH. Methods: The study analyzed data from 190 patients diagnosed with AIH at our institution between 1990 and 2015. Their histological liver fibrosis progression and clinical long-term prognosis were evaluated retrospectively (cohort 1). In 90 patients, receiver operating characteristic (ROC) curves were compared to choose severe fibrosis cases with respect to existing indices (FIB-4, APRI, and Forns index) and the ferritin–zinc ratio (cohort 2). Results: In cohort 1, liver-related death and hepatocellular carcinoma rates were significantly higher in the severe (n = 27) than in the mild (n = 63) fibrosis group (p = 0.0001 and 0.0191, respectively). In cohort 2, liver-related death in the severe fibrosis group was significantly frequent (p = 0.0071), and their ferritin–zinc ratio was higher (median 2.41 vs. 0.62, p = 0.0011). ROC analyses were performed to compare the ability of the ferritin–zinc ratio, FIB-4, APRI, and the Forns index to predict severe and mild fibrosis. Accordingly, areas under the ROC were 0.732, 0.740, 0.721, and 0.729, respectively. Conclusions: The serum ferritin–zinc ratio can noninvasively predict liver fibrosis progression in AIH and be applied to predict long-term prognosis.
Keywords: autoimmune hepatitis; zinc; ferritin; liver fibrosis; biomarker autoimmune hepatitis; zinc; ferritin; liver fibrosis; biomarker

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MDPI and ACS Style

Moriya, K.; Sato, S.; Nishimura, N.; Kawaratani, H.; Takaya, H.; Kaji, K.; Namisaki, T.; Uejima, M.; Nagamatsu, S.; Matsuo, H.; et al. Efficacy of Serum Ferritin–Zinc Ratio for Predicting Advanced Liver Fibrosis in Patients with Autoimmune Hepatitis. J. Clin. Med. 2023, 12, 4463. https://doi.org/10.3390/jcm12134463

AMA Style

Moriya K, Sato S, Nishimura N, Kawaratani H, Takaya H, Kaji K, Namisaki T, Uejima M, Nagamatsu S, Matsuo H, et al. Efficacy of Serum Ferritin–Zinc Ratio for Predicting Advanced Liver Fibrosis in Patients with Autoimmune Hepatitis. Journal of Clinical Medicine. 2023; 12(13):4463. https://doi.org/10.3390/jcm12134463

Chicago/Turabian Style

Moriya, Kei, Shinya Sato, Norihisa Nishimura, Hideto Kawaratani, Hiroaki Takaya, Kosuke Kaji, Tadashi Namisaki, Masakazu Uejima, Shinsaku Nagamatsu, Hideki Matsuo, and et al. 2023. "Efficacy of Serum Ferritin–Zinc Ratio for Predicting Advanced Liver Fibrosis in Patients with Autoimmune Hepatitis" Journal of Clinical Medicine 12, no. 13: 4463. https://doi.org/10.3390/jcm12134463

APA Style

Moriya, K., Sato, S., Nishimura, N., Kawaratani, H., Takaya, H., Kaji, K., Namisaki, T., Uejima, M., Nagamatsu, S., Matsuo, H., & Yoshiji, H. (2023). Efficacy of Serum Ferritin–Zinc Ratio for Predicting Advanced Liver Fibrosis in Patients with Autoimmune Hepatitis. Journal of Clinical Medicine, 12(13), 4463. https://doi.org/10.3390/jcm12134463

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