Apolipoprotein A1 is a Serum and Tissue Marker of Liver Fibrosis in Alcoholic Patients

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Abstract
The aim of this study was to assess the specific correlation of apolipoprotein-Al to hepatic fibrosis in alcoholic patients. Four hundred eighty two patients were prospectively included with serum measurement of apolipoprotein-Al within 10 days before liver biopsy. Pathologic features were semiquantitatively assessed by two observers. In 28 patients liver biopsy was used for histomorphometric assessment of fibrosis and immunohistochemical labeling of apolpoprotein-Al. Serum apolipoprotein-Al was negatively correlated to semiquantitative score of fibrosis (r=-0.50; p < 0.001), independently of the scores of steatosis and alcoholic hepatitis (r=-0.44; p < 0.001) and of the value of serum albumin, bilirubin, and prothrombin time (r=-0.22; p < 0.001) and independently of the nutritional parameters (r=-0.29; p < 0.009). The mean value of apolipoprotein-Al decreased according to the grade of fibrosis from 220 .+-. 6 mg/dl (mean .+-. SEM) to 110 .+-. 8 mg/dl. Serum apolipoprotein-Al was negatively correlated to the percentage of fibrosis (r=-0.70; p < 0.001) in the biopsies morphometrically assessed. The labeling was superimposed to the extracellular matrix. In conclusion, this study shows that decrease of apolipoprotein-Al is a serum and tissue marker of liver fibrosis independently of steatosis, alcoholic hepatitis, liver function tests, and nutritional parameters.