Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2016; 22(5): 1884-1890
Published online Feb 7, 2016. doi: 10.3748/wjg.v22.i5.1884
Association between serum α-L-fucosidase and non-alcoholic fatty liver disease: Cross-sectional study
Zhen-Ya Lu, Chao Cen, Zhou Shao, Xin-Hua Chen, Cheng-Fu Xu, You-Ming Li
Zhen-Ya Lu, Department of Internal Medicine, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Chao Cen, Zhou Shao, Xin-Hua Chen, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Cheng-Fu Xu, You-Ming Li, Department of Gastroenterology, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Lu ZY and Cen C contributed equally to this work; Lu ZY, Cen C and Chen XH designed the research; Lu ZY collected the data; Cen C, Shao Z, Chen XH and Xu CF analyzed the data; Cen C and Xu CF wrote the paper; all authors have read and approved the final version to be published.
Supported by National Key Basic Research Development Program, No. 2012CB524905; National Science and Technology Support Plan Project, No. 2012BAI06B04; National Natural Science Foundation of China, No. 81100278, No. 81170378, No. 81230012 and No. 81270487; International Science and Technology Cooperation Projects of Zhejiang Province, No. 2013C24010; and Science Fund of Health Bureau of Zhejiang Province, No. 2012RCA026.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of the First Affiliated Hospital of Zhejiang University School of Medicine.
Informed consent statement: All participants were informed verbally about the purpose and design of the study. The study was approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang University School of Medicine.
Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this study.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author at xiaofu@zju.edu.cn.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: You-Ming Li, MD, FACP, Professor, Department of Gastroenterology, the First Affiliated Hospital of Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. xiaofu@zju.edu.cn
Telephone: +86-571-87236532 Fax: +86-571-87236611
Received: July 11, 2015
Peer-review started: July 18, 2015
First decision: August 26, 2015
Revised: September 20, 2015
Accepted: November 19, 2015
Article in press: November 19, 2015
Published online: February 7, 2016
Processing time: 188 Days and 19.1 Hours
Abstract

AIM: To explore the association between serum α-L-fucosidase (AFU) and non-alcoholic fatty liver disease (NAFLD).

METHODS: A total of 16473 individuals (9456 men and 7017 women) were included in the current study, who presented for a health examination at the First Affiliated Hospital of Zhejiang University School of Medicine in 2014. The baseline characteristics of the cohort were compared by NAFLD status. Linear regression analysis and stepwise multiple regression analysis were applied to assess the risk factors for NAFLD. Receiver operating characteristic curve was used to determine the sensitivity and specificity of AFU in the diagnosis of NAFLD.

RESULTS: The prevalence rates of NAFLD and metabolic syndrome (MetS) were 38.0% and 25.4%, respectively. The NAFLD group had significantly higher AFU levels than the non-NAFLD group (28.7 ± 7.9 U/L vs 26.0 ± 7.3 U/L, P < 0.001) and the prevalence rate of NAFLD increased with progressively higher serum AFU levels. AFU was positively correlated with MetS and its five components: central obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, and elevated blood pressure and fasting glucose. Stepwise multiple logistic regression analysis showed that AFU was associated with an increased risk of NAFLD (OR = 1.009, 95%CI: 1.003-1.014, P < 0.001). The best cut-off value of AFU for the diagnosis of NAFLD was 27.5 U/L. The area under the curve (diagnostic efficacy index) was 0.606. The sensitivity and specificity were 54.6% and 61.8%, respectively.

CONCLUSION: AFU level is significantly associated with NAFLD, and elevated AFU level is an independent risk factor for NAFLD.

Keywords: α-L-fucosidase; Biomarker; Non-alcoholic fatty liver disease; Metabolic syndrome; Cross-sectional study

Core tip: Alpha-L-fucosidase (AFU) is a well-established marker for hepatocellular carcinoma. This study was the first attempt to investigate the relationship between AFU level and non-alcoholic fatty liver disease (NAFLD) in a large cross-sectional cohort from a southern urban Han Chinese population. It provided evidence that AFU level was significantly associated with NAFLD, and elevated AFU level was an independent risk factor for NAFLD. AFU may be a potential biomarker for the diagnosis of NAFLD.