Assessing the role of Mac-2 binding protein glycosylation isomer in the management of patients with chronic hepatitis B

Abstract

BACKGROUND

The Mac-2 binding protein glycosylated isomer (M2BPGi) is a serum marker for fibrosis that correlates with the fibrosis stages in various liver diseases.

AIM

To examine the M2BPGi’s threshold for staging fibrosis in patients with chronic hepatitis B (CHB), and its changes during treatment.

METHODS

This was a prospective, longitudinal study. A total of 348 eligible patients were recruited from the Hepatology Department, Medic Medical Center between March 2020 and December 2023. Liver enzyme tests, platelet counts, M2BPGi levels, and FibroScan were conducted at baseline and at 3-month intervals until six months post-treatment. Correlation plots of M2BPGi, FibroScan, and the other parameters were generated. Receiver operating characteristic curves were constructed for M2BPGi and the other parameters to evaluate their performance.

RESULTS

M2BPGi levels correlated well with FibroScan results and increased as the fibrosis stage advanced. The median M2BPGi levels at the different stages of fibrosis showed statistically significant differences. The cut-off values of M2BPGi for diagnosing significant fibrosis (F ≥ 2), advanced fibrosis (F3), and cirrhosis (F4) were determined to be 1.08, 1.4, and 1.52, respectively. In the context of fibrosis regression in CHB patients during the first 6-month of treatment, M2BPGi levels appeared to decrease before this pattern occurred in the FibroScan results.

CONCLUSION

M2BPGi levels were strongly correlated with FibroScan. M2BPGi can be used to assess liver fibrosis, and to serve as a tool for monitoring fibrosis regression in CHB patients undergoing treatment.

Keywords: Chronic hepatitis B; Liver fibrosis; Cirrhosis; Mac-2 binding protein glycosylation; FibroScan; Hepatic stellate cells

Core Tip: The study highlights the innovative use of the Mac-2 binding protein glycosylated isomer (M2BPGi) as a non-invasive serum marker for assessing liver fibrosis in patients with chronic hepatitis B. It establishes specific cut-off values for M2BPGi to distinguish between significant fibrosis (F ≥ 2), advanced fibrosis (F3), and cirrhosis (F4). The research demonstrates a strong correlation between M2BPGi levels and transient elastography results, suggesting its reliability. Moreover, the study reveals M2BPGi’s potential in monitoring fibrosis regression during antiviral treatment, offering a valuable tool for clinical practice, particularly when advanced imaging options are unavailable.