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Table 1 Characteristics of studies evaluating serum markers in alcoholic liver disease

From: Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease

Study Author: Yr published (date of study when reported) Country(No. centres) Total no patients Patient selection Alcohol consumption inclusion criteria % cirrhosis (significant fibrosis*) Age Yr mean (SD) % male Liver biopsy scoring system Serum marker or panel
   Recruitment details (where reported)    Fibrosis stages   Length biopsy/no portal triads  
Gabrielli 1989 [15] Italy (1) 44 Patients with ALD on biopsy /clinical n/r n/r 52 84 Local n/r PIIINP
Consecutive prospective recruitment fibrosis 29% no fibrosis 15%
Poynard 1991 [16] (1982–1987) France (1) 624 Patients admitted with alcoholism or diagnosed ALD ≥ 50 g alcohol daily for last 5 years 29 (11) 49 75 Local n/r PGA (GGT PT Apo A1)PT
(a) 333 training 24% no fibrosis
(b) 291 validation Consecutive prospective recruitment
Li 1994 [17] USA (1) 44 Patients undergoing biopsy for clinical reason. with h/o heavy alcohol >80 g daily at least 5 years 23 (70) 45 (range 100 Local n/r PIIINP TIMP 1
Prospective recruitment Periven fibrosis 23% 227–69)
Oberti 1997 [18] France(1) 160 total (a)109 compensated Admissions for alcoholism/ diagnosed ALD >50 g alcohol daily for 5 years with abn AST > 6 m 59 65 n/r modified METAVIR n/r HA
Consecutive prospective recruitment PT
Tran 2000 [19, 20] (1997–1998) 146 Heavy drinkers admitted for detoxification+/−rehabilitation >80 g alcohol daily for >5 year 40 (51) 49 73 Local n/r HA
PGA
YKL
France(1)   Consecutive prospective recruitment Tran index
(HA; PT; Apo A1)
Plevris 2000 [21] 70 Patients with ALD diagnosed by histology n/r n/r n/r n/r Local n/r HA
Prospective recruitment
Croquet 2002 [22] 240 Patients admitted for alcoholism or ALD 50 g daily past 5 years 48 (74) n/r n/r METAVIR PT
20 ± 7 mm
(≥10 mm in 98% cases)
France(1)   Prospective recruitment 12 ± 5 portal tracts
Study Author: Yr published (date of study) country No. centres Total no patients Patient selection Alcohol consumption inclusion criteria % cirrhosis (significant fibrosis*) Age Yr mean (SD) % male Liver biopsy scoring system Serum marker
Recruitment details (where reported Length biopsy/no portal triads
Stickel 2003 [23] Germany (1) 87 Admissions for alcohol withdrawal symptoms in current drinkers >100 g alcohol daily 14 (44) n/r n/r Local; Ludwig; Knodell n/r HA
  Steatosis + mild fibrosis 23%
Steatosis + mod fibrosis + inflam 8%
Severe fib + inflam 30%
Rosenberg 2004 [24] (1998–2000) England (8) Germany Italy Sweden 64 Patients with excess alcohol consumption history and histology Assessed by each centre 27 44 63 Scheuer ELF panel
Ishak (HA TIMP1 PIIINP age)
Consecutive prospective recruitment ≥12 mm ≥5 portal tracts
Naveau 2005 [25] (1996–2000) France(1) 221 Patients with active history of excess alcohol consumption admitted to hospital (24% decompensated cirrhosis) and with available histology >50 g alcohol daily for 1 year 31(64) 47 77 METAVIR Fibrotest (α2M, apoA1, bilirubin, GGT, haptogloblin, corrected for age + sex)
Stage 0 7% Mean length 15 mm ± 05
  Stage 1 329%
Stage 2 22% Frags = 2.2 ± 0.1
Prospective recruitment Stage 3 11% portal tr 14.4 ± 0.7 HA
Stage 4 31%
Cales 2005 [26] (1994–2002) France (1) 95 Heavy drinkers with ALD on histology >50 g daily >5 years 41 (80) 49.8 (11.2) 71.6 METAVIR Fibrometer (PT α2M HA)
   Consecutive prospective recruitment   Stage 0 13%    Median Length 18.4 ±6.0  
Stage 1 18%
Stage 2 17%
Stage 3 12%
Stage 4 41%
Lieber 2006 [27] USA (23) 1034: (a) 507 pre-cirrhotic (b) 527 decompensated cirrhosis Patients with heavy alcohol consumption + fibrosis/cirrhosis on biopsy/clinical in 2 treatment RCTs 80 g ethanol daily >5 years HCV negative 51(66) (a) 51 98 Ishak APRI
(b) 56 n/r (AST Platelets)
   Prospective recruitment
Study Author: Yr published (date of study) country No. centres Total no patients Patient selectionrecruitment details (where reported) Alcohol consumption inclusion criteria % cirrhosis (significant fibrosis*) Age Yr mean (SD) % male Liver biopsy scoring system Serum marker
  Mean length mm/no portal tracts
Nguyen –Khac 2008 [28] 103 Patients with attending hepato-GI, alcoholism & Int Med depts. who were HBV- and HCV- without decompensated cirrhosis who agreed to have liver biopsy >50 g daily alcohol for >5 yrs 33 (75) 53 (9.6) 74 METAVIR HA
Stage 0 8% length 12.2 ±3 mm Hepascore
Stage 1 18% Portal tracts 7.8 ± 2.7 (bilirubin GGT HA age,sex α2M)
Stage 2 23%  
Stage 3 19%   PGA
Prospective recruitment Stage 4 32% PGAA (PT GGT α2M, apoA1)
APRI(AST Pl)
Fibrotest
Fibrometer
*(fibroscan)
Lieber 2008 [29] (1994–2000) 247 Heavy alcohol consumption and fibrosis on biopsy ≥80 g daily . ≥5 years (~16 drinks daily for mean 19 yrs) (45) 50 98 Worner & Lieber n/r HA
Mild fibrosis 55% TIMP1
P3NP
Naveau 2009 [30] (1996–2000 same population as 2005 paper) France (1) 218 Heavy alcohol consumption and available liver biopsy HCV- HIV- ≥50 g alcohol daily for1previous year 31 (63) 47 (0.07) 78 METAVIR FT
Stage 0 7% Biopsy/ serum ≤1 month apart Fibrometer (HA PT α2M)
Retrospective Stage 1 30%
Stage 2 22% Mean length 15 mm ± 05 Hepascore (α2M GGT Bilirubin HA)
Stage 3 10% No frags 2.2 ± 0.1portal tr 14.4 ± 0.7
Stage 4 31% Forns (age GGT cholesterol pl)
APRI
FIB4 (platelets ALT AST)
  1. *(Significant fibrosis METAVIR stages 2-4: Ishak 3-6).