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CN 22-1108/R
Volume 37 Issue 5
May  2021
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Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(5): 1075-1080

Clinical significance of serum protoporphyrin Ⅸ measurement in patients with HBV-related chronic liver diseases

DOI: 10.3969/j.issn.1001-5256.2021.05.020
  • 1.

    Department of Rehabilitation Medicine, The Second Affiliated Hospital of Xi'an Medical University, Xi'an 710038, China

  • 2.

    Class 1625 of School of Clinical Medicine, Xi'an Medical University, Xi'an 710068, China

  • 3.

    Department of Geriatrics, Xianyang Central Hospital, Xianyang, Shaanxi 712000, China

  • 4.

    Department of Gastroenterology, The First Afftliated Hospital of Xi'an Medical University, Xi'an 710077, China

  • Received Date: 2020-12-06
  • Accepted Date: 2021-01-26
  • Published Date: 2021-05-20
    Abstract
  •   Objective  To investigate the value of serum protoporphyrin Ⅸ (PPIX) measurement in evaluating liver damage in patients with HBV-related chronic liver diseases.  Methods  A total of 110 patients who were diagnosed with HBV-related chronic liver diseases in The First Affiliated Hospital of Xi'an Medical University from October 2018 to October 2019 were enrolled as case group [chronic hepatitis B (CHB) group with 50 patients, liver cirrhosis (LC) group with 40 patients, and hepatocellular carcinoma (HCC) group with 20 patients], and 40 healthy individuals were enrolled as control group. High-performance liquid chromatography was used to measure serum PPIX. A one-way analysis of variance was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test or the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups; the receiver operating characteristic (ROC) curve was plotted to analyze diagnostic value; a Spearman correlation analysis was also performed to investigate correlation.  Results  The CHB, HC, and HCC groups had a significantly higher level of PPIX than the control group [44.29 (25.99-85.36) ng/dl, 72.73 (48.28-90.43) ng/dl, and 91.79 (68.34-121.52) ng/dl vs 15.43 (10.87-20.16) ng/dl, all P < 0.05], and the patients with decompensated LC had a significant increase in the level of PPIX compared with those with compensated LC [54.50(29.14~85.65) vs 76.09(53.47~104.37), Z=-2.176, P < 0.05]. PPIX had a sensitivity of > 85% and a specificity of > 60% in the diagnosis of CHB, LC, and HCC. The patients in the latent stage of CHB had a significantly higher level of PPIX than those in the control group (Z=-4.303, P < 0.05). In the patients with LC, PPIX was moderately positively correlated with total bilirubin (TBil) (rs=0.587, P < 0.05) and moderately negatively correlated with albumin (rs=-0.408, P < 0.05); in the patients with HCC, PPIX was moderately positively correlated with TBil (rs=0.470, P < 0.05) and moderately negatively correlated with cholinesterase (rs=-0.459, P < 0.05).  Conclusion  Elevated serum PPIX is an early event of liver damage in patients with HBV-related chronic liver diseases and can thus be used as a sensitive parameter for the early warning and assessment of liver damage.

     

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