Plasma sphingolipids as potential indicators of hepatic necroinflammation in patients with chronic hepatitis C and normal alanine aminotransferase level.

ABSTRACT: Accurate estimation of hepatic necroinflammation caused by chronic hepatitis C (CHC) is crucial for prediction of prognosis and design of therapeutic strategy, which is particularly true for CHC patients with normal alanine aminotransferase (ALT) level. Recent studies have shown that sphingolipids have a close relationship with hepatitis C virus infection. The present study aimed to identify plasma sphingolipids related to hepatic necroinflammation. We included 120 treatment-naïve CHC patients and 64/120 had normal ALT levels (<40 U/L). CHC patients who underwent liver biopsies were subjected to Scheuer scoring analysis for scope of hepatic inflammation. Plasma sphingolipids were detected by high-performance liquid chromatography tandem mass spectrometry. Our results showed 44 plasma sphingolipids were detected altogether. Of all detected sphingolipids, hexosylceramide (HexCer) (d18?1/22?0) and HexCer (d18?1/24?0) showed a significant difference among G0/G1, G2, and G3/G4 (P<0.05). For identifying hepatic necroinflammation (G?2), after adjusting other factors, the odds ratio (OR) of HexCer (d18?1/22?0) reached 1.01 (95% confidence interval [CI]: 1.00-1.02). Furthermore, the area under the curve (AUC) of HexCer (d18?1/22?0) was 0.7 (P?=?0.01) and approached that of ALT (AUC?=?0.78). However, in CHC patients with normal ALT, HexCer (d18?1/22?0) was an independent factor (OR: 1.02, 95% CI: 1.01-1.03) to identify the hepatic necroinflammation (G?2). HexCer (d18?1/22?0) not only showed the largest AUC (0.78, P?=?0.001), but also exhibited the highest specificity of all indicators. These results indicate that plasma HexCer (d18?1/22?0) is a potential indicator to distinguish hepatic necroinflammation in CHC patients. For CHC with normal ALT, the ability of HexCer (d18?1/22?0) to distinguish hepatic necroinflammation might be superior to conventional serum indicators.

SUBMITTER: Li JF 

PROVIDER: S-EPMC3988168 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature