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A model incorporating serum C3 complement levels may be useful for diagnosing biliary atresia in infants
Institution:1. Department of Pediatric Surgery, Guangzhou Women and Children''s Medical Center, Guangzhou Medical University, Guangzhou, China;2. Guangzhou Institute of Pediatrics, Guangzhou Women and Children''s Medical Center, Guangzhou Medical University, Guangzhou, China;3. Isolation Clinic, Guangzhou Women and Children''s Medical Center, Guangzhou Medical University, Guangzhou, China;1. Servicio de Cirugía General y del Aparato Digestivo, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, España;2. Servicio de Anatomía Patológica, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, España;1. Departamento de Gastroenterología, Hepatología y Unidad de Trasplante Hepático, Hospital Universitari y Politècnic La Fe, Valencia, España;2. Instituto de Investigación Sanitaria La Fe, Valencia, España;3. Cirugía General y del Aparato Digestivo, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Tenerife, España;4. Centro de Investigación Biomédica en Red del Área de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, España;5. Departamento de Medicina, Universitat de València, Valencia, España
Abstract:IntroductionCorrectly identifying patients with biliary atresia (BA), while avoiding invasive diagnostic methods is challenging. The purpose of this study was to determine the value of serum immune indicators for distinguishing BA from other causes of cholestasis in infants.Patients and methodsThe data of infants with a surgical/histological diagnosis of BA and those with other causes of cholestatic jaundice were retrospectively analyzed. Patients were divided into a BA group and a cholestasis control (CC) group. Biochemical parameters, major lymphocyte subsets, immunoglobin and C3 and C4 complement levels were compared between the groups.ResultsA total of 129 infants with BA and 63 with other causes of cholestasis (CC control group) with a median age of 2.2 months were included in the analysis. The levels of CD3+ T cells, CD3+CD4+ T cells, and premature T cells and the levels of C3 and C4 were all significantly higher in the BA group compared to the CC group (all P < 0.05). Pair-wise correlation analyses indicated that C3 and C4 had a significant positive correlation with γ-GT in the BA group, but not in the CC group. Five indices were found to be significantly associated with BA: stool color, globulin, γ-GT, C3 and C4. A model incorporating stool color, gamma-glutamyl transpeptidase level, and C3 level exhibited an area under the ROC curve (AUC) of 0.93, and a sensitivity of 93% and specificity of 83% for the diagnosis of BA.ConclusionsModels incorporating serum C3 levels may be useful for accurately diagnosing BA in infants.
Keywords:Biliary atresia  Complement  Gamma-glutamyl transpeptidase  Diagnosis  Atresia biliar  Complemento  Gamma-glutamil transpeptidasa  Diagnóstico  BA"}  {"#name":"keyword"  "$":{"id":"kw0050"}  "$$":[{"#name":"text"  "_":"biliary atresia  CC"}  {"#name":"keyword"  "$":{"id":"kw0060"}  "$$":[{"#name":"text"  "_":"cholestasis control  WBC"}  {"#name":"keyword"  "$":{"id":"kw0070"}  "$$":[{"#name":"text"  "_":"white blood cell  AST"}  {"#name":"keyword"  "$":{"id":"kw0080"}  "$$":[{"#name":"text"  "_":"aspartate aminotransferase  ALT"}  {"#name":"keyword"  "$":{"id":"kw0090"}  "$$":[{"#name":"text"  "_":"alanine aminotransferase  γ-GT"}  {"#name":"keyword"  "$":{"id":"kw0100"}  "$$":[{"#name":"text"  "_":"gamma-glutamyl transpeptidase  ELISAR"}  {"#name":"keyword"  "$":{"id":"kw0110"}  "$$":[{"#name":"text"  "_":"enzyme-linked immunosorbent assay  ROC"}  {"#name":"keyword"  "$":{"id":"kw0120"}  "$$":[{"#name":"text"  "_":"receiver operating characteristic  PPV"}  {"#name":"keyword"  "$":{"id":"kw0130"}  "$$":[{"#name":"text"  "_":"positive predictive value  NAFLD"}  {"#name":"keyword"  "$":{"id":"kw0140"}  "$$":[{"#name":"text"  "_":"non-alcoholic fatty liver disease
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