Fibrogenesis Marker PRO-C3 Is Higher in Advanced Liver Fibrosis and Improves in Patients Undergoing Bariatric Surgery.

Abstract

CONTEXT:

Serum propeptides of type III and type VI collagen (PRO-C3 and PRO-C6) are elevated in advanced nonalcoholic fatty liver disease (NAFLD), but their value in patients with severe obesity and their evolution after bariatric surgery (BS) is unknown. It is unclear if these markers of fibrogenesis are affected by adipose tissue fibrosis (ATF).

OBJECTIVE:

We studied the association of PRO-C3 and PRO-C6 with liver fibrosis before BS, examined their evolution after BS, and evaluated how much patients' ATF contribute to their levels.

METHODS:

Serum PRO-C3 and PRO-C6 were measured in 158 BS patients and compared with liver, subcutaneous, and omental adipose tissue histology obtained during surgery. PRO-C3 and PRO-C6 levels of 63 patients were determined in follow-up at 3 and 12 months post-BS.

RESULTS:

Patients in the highest quartile of PRO-C3 had a higher risk of advanced liver fibrosis (stage F3-4; odds ratio 5.8; 95% CI [1.5-29.9]; P = 0.017) vs the lowest quartile (adjustment for age, gender, and BMI). PRO-C3 was positively correlated with markers of insulin resistance and liver enzymes. After BS, PRO-C3 levels decreased in patients with high baseline liver fibrosis. This decrease correlated with improvement of metabolic and liver parameters. PRO-C6 was not related to stage of liver fibrosis. ATF did not correlate with PRO-C3 or PRO-C6 levels at baseline or after BS.

CONCLUSION:

PRO-C3 was associated with advanced liver fibrosis in patients with severe obesity, and decreased after BS, without being affected by ATF. These data suggest that BS prominently eliminates drivers of hepatic fibrogenesis in NAFLD.

• Authors: Pierre Bel Lassen, Nicole Nori, Pierre Bedossa, Laurent Genser, Judith Aron-Wisnewsky, Christine Poitou, Rambabu Surabattula, Mette Juul Nielsen, Morten Asser Karsdal, Diana Julie Leeming, Detlef Schuppan, Karine Clément
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 107 Issue 4 Pg. e1356-e1366 (03 24 2022) ISSN: 1945-7197 [Electronic] United States
• PMID: 34905051 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Biomarkers
• Complement C3

Topics

• Bariatric Surgery
• Biomarkers
• Complement C3 (analysis)
• Fibrosis
• Humans
• Liver (metabolism)
• Liver Cirrhosis (etiology, surgery)
• Non-alcoholic Fatty Liver Disease (complications, surgery)
• Obesity, Morbid (metabolism)