Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2017; 23(36): 6705-6714
Published online Sep 28, 2017. doi: 10.3748/wjg.v23.i36.6705
Serum angiotensin-converting enzyme level for evaluating significant fibrosis in chronic hepatitis B
Ryuichi Noguchi, Kosuke Kaji, Tadashi Namisaki, Kei Moriya, Mitsuteru Kitade, Kosuke Takeda, Hideto Kawaratani, Yasushi Okura, Yosuke Aihara, Masanori Furukawa, Akira Mitoro, Hitoshi Yoshiji
Ryuichi Noguchi, Kosuke Kaji, Tadashi Namisaki, Kei Moriya, Mitsuteru Kitade, Kosuke Takeda, Hideto Kawaratani, Yasushi Okura, Yosuke Aihara, Masanori Furukawa, Akira Mitoro, Hitoshi Yoshiji, Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara 634-8522, Japan
Author contributions: Noguchi R and Kaji K contributed equally to this work; Noguchi R and Kaji K collected and analyzed the data, and drafted the manuscript; Namisaki T, Moriya K, Kitade M, Takeda T, Kawaratani H, Okura Y, Aihara Y, Furukawa M and Mitoro A offered the technical or material support; Yoshiji H designed and supervised the study; all authors have read and approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Nara Medical University (Nara, Japan; Approval number 1077).
Informed consent statement: Waiver of informed consent for all study participants was guaranteed by information disclosure on website (http://www.naramed-u.ac.jp/~3int/kenkyu.html).
Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this paper.
Data sharing statement: Informed consent for data sharing was not obtained but the presented data are anonymized and risk of identification is low.
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: Kosuke Kaji, MD, PhD, Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan. kajik@naramed-u.ac.jp
Telephone: +81-744-223051 Fax: +81-744-247122
Received: March 22, 2017
Peer-review started: March 23, 2017
First decision: April 21, 2017
Revised: May 1, 2017
Accepted: June 18, 2017
Article in press: June 19, 2017
Published online: September 28, 2017
Core Tip

Core tip: Liver fibrosis is one of key factors to determine therapeutic intervention for patients with chronic hepatitis B (CHB). However, the noninvasive prediction of CHB-related liver fibrosis is difficult. Angiotensin-converting enzyme (ACE) is reportedly involved in liver fibrogenesis. In this paper, we demonstrate that serum ACE levels are elevated in patients with CHB and show the predictive potential to diagnose significant fibrosis (≥ F2), which is the therapeutically adapted stage, with higher accuracy as compared with other fibrotic markers including APRI, FIB-4, M2BPGi and Plt. The serum ACE level could be a novel noninvasive marker of significant fibrosis stage in CHB.