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

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)