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Volume 9
Issue 12
10.3390/biomedicines9121920
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Systematic Review

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

by
Anne Linde Mak
1,*,
Jenny Lee
2,
Anne-Marieke van Dijk
1,
Yasaman Vali
2,
Guruprasad P. Aithal
3,
Jörn M. Schattenberg
4,
Quentin M. Anstee
5,
M. Julia Brosnan
6,
Mohammad Hadi Zafarmand
2,
Dewkoemar Ramsoekh
7,
Stephen A. Harrison
8,
Max Nieuwdorp
1,
Patrick M. Bossuyt
2 and
Adriaan G. Holleboom
1
1
Department of Vascular Medicine, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands
2
Department of Epidemiology and Data Science, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands
3
NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK
4
Metabolic Liver Research Program, Department of Medicine, University Medical Centre, Johannes Gutenberg University, 55131 Mainz, Germany
5
The Newcastle Liver Research Group, Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
6
Internal Medicine Research Unit, Pfizer Inc., Cambridge, MA 02139, USA
7
Department of Gastroenterology and Hepatology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
8
Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
*
Author to whom correspondence should be addressed.
Biomedicines 2021, 9(12), 1920; https://doi.org/10.3390/biomedicines9121920
Submission received: 4 November 2021 / Revised: 3 December 2021 / Accepted: 10 December 2021 / Published: 15 December 2021
(This article belongs to the Special Issue NAFLD: From Mechanisms to Therapeutic Approaches)
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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.
Keywords: fatty liver; biomarker; Pro-C3; collagen type III; fibrosis; liver disease fatty liver; biomarker; Pro-C3; collagen type III; fibrosis; liver disease

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MDPI and ACS Style

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.; et al. Systematic Review with Meta-Analysis: Diagnostic Accuracy of Pro-C3 for Hepatic Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease. Biomedicines 2021, 9, 1920. https://doi.org/10.3390/biomedicines9121920

AMA Style

Mak AL, Lee J, van Dijk A-M, Vali Y, Aithal GP, Schattenberg JM, Anstee QM, Brosnan MJ, Zafarmand MH, Ramsoekh D, et al. Systematic Review with Meta-Analysis: Diagnostic Accuracy of Pro-C3 for Hepatic Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease. Biomedicines. 2021; 9(12):1920. https://doi.org/10.3390/biomedicines9121920

Chicago/Turabian Style

Mak, Anne Linde, Jenny Lee, Anne-Marieke van Dijk, Yasaman Vali, Guruprasad P. Aithal, Jörn M. Schattenberg, Quentin M. Anstee, M. Julia Brosnan, Mohammad Hadi Zafarmand, Dewkoemar Ramsoekh, and et al. 2021. "Systematic Review with Meta-Analysis: Diagnostic Accuracy of Pro-C3 for Hepatic Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease" Biomedicines 9, no. 12: 1920. https://doi.org/10.3390/biomedicines9121920

APA Style

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), 1920. https://doi.org/10.3390/biomedicines9121920

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