Pro-Neurotensin as a Potential Novel Diagnostic Biomarker for Detection of Nonalcoholic Fatty Liver Disease

Figures & data

Table 1 Demographic and Biochemical Parameters Between NAFLD Patients and Controls

	NAFLD Group (n=157) (Range, Median and IQR)	Control Group (n=100)) (Range, Median and IQR)	P-value
Age (years)	28–80	19–77	<0.001
	56 (50–61)	38 (32–47)
Gender (n, %)
Male	86 (54.8%)	57 (57.0%)	0.727
Female	71 (46.2%)	43 (43.0%)
BMI (kg/m^2)	22–41	20–35	<0.001
	30 (25–35)	25 (21–30)
BMI (n, %)
Average (20 - < 25)	17 (10.8%)	45 (45%)	<0.001
Overweight (25 - < 30)	46 (29.3%)	31 (31%)
Obese (> 30)	94 (59.9%)	34 (34%)
ALT (IU/L)	19–66	20–41	0.001
	34 (28–44.5)	29 (26–36)
AST (IU/L)	24–125	24–58	<0.001
	45 (34–64)	35 (26–38)
Total Bilirubin (mg/dl)	0.3–2.3	0.4–1.0	<0.001
	1.0 (0.8–1.3)	0.8 (0.65–0.9)
Serum Albumin (g/L)	2.1–4.3	3.6–4.3	<0.001
	3.7 (3.3–3.9)	3.8 (3.6–4.0)
INR	1.0–2.18	0.9–1.2	<0.001
	1.27 (1.19–1.43)	0.98 (0.95–1.0)
ALP (IU/L)	12–468	20–41	0.001
	86 (71–133.25)	29 (26–36)
GGT (IU/L)	15–105	24–59	<0.001
	57 (40–70)	36 (25.5–41)
AFP (IU/L)	4–45	2.9–23	<0.001
	9 (7–13)	6 (5–7)
Serum Creatinine (IU/L)	0.4–1.21	0.7–1.21	0.679
	1.0 (0.8–1.1)	1.0 (0.8–1.1)
Hemoglobin (g/dl)	7.8–15.8	7.8–16.0	0.516
	10.6 (10–12.3)	10.7 (10–12.65)
Total leucocytic count (x 1000/cmm)	2.7–29	2.0–29	0.920
	7.1 (4.4–9.01)	6.35 (4.4–8.9)
C-reactive protein (mg/dl)	1.02–56	0.2–18	<0.001
	14.0 (10–25)	5.0 (4.0–6.5)
Serum Triglycerides (mg/dl)	87–300	121–245	<0.001
	190 (170–200)	152 (134.5–165)
Serum Cholesterol (mg/dl)	160–270	100–256	<0.001
	190 (180–202.5)	156 (150–186)
Serum HDL (mg/dl)	20–60	22–60	<0.001
	32 (29–42.25)	42 (39.5–45)
Serum LDL (mg/dl)	99–202	89–167	<0.001
	120 (102–150.5)	107.5 (102–125)

Note: P value is significant if <0.05 and non-significant if >0.05.

Abbreviations: IQR, interquartile range; BMI, body mass index; ALT, alanine transaminase; AST, aspartate transaminase; INR, international normalized ratio; ALP, alkaline phosphatase; GGT, gamma-glutamyltransferase; AFP, alpha-feto protein; HDL, high-density lipoprotein; LDL, low-density lipoprotein.

Table 2 Difference Between Groups Regarding Serum Proneurotensin and Micro-RNA-122 Assay

	NAFLD Group (n=157) (Range, Median and IQR)	Control Group (n=100) (Range, Median and IQR)	P-value
Serum Proneurotensin (pmol/L)	27–200	34–180	<0.001
	156 (138.3–177)	80 (70–98)
Micro-RNA 122	1.0–90.51	1.0–64.0	<0.001
	8.0 (2.0–32.0)	2.0 (1.4–98)

Note: P value is significant if <0.05 and non-significant if >0.05.

Table 3 Correlation Between Each of Serum Proneurotensin and Micro-RNA-122 and Other Measured Variables in NAFLD Group

NAFLD Group (n=157)	Micro-RNA 122	Proneurotensin
Age	0.059 (p=0.343)	0.015 (p=0.854)
BMI	0.012 (p=0.844)	0.019 (p=0.813)
Hb	0.016 (p=0.794)	0.196 (p=0.014)
Total leucocytic count	0.146 (p=0.019)	−0.186 (p=0.020)
CRP	0.150 (p=0.016)	−0.078 (p=0.332)
AFP	0.163 (p=0.009)	0.091 (p=0.261)
Albumin	−0.097 (p=0.119)	−0.052 (p=0.524)
INR	0.293 (p<0.001)	−0.032 (p=0.688)
ALP	0.138 (p=0.027)	0.046 (p=0.566)
GGT	0.058 (p=0.351)	0.184 (p=0.021)
Total Bilirubin	0.268 (p<0.001)	0.026 (p=0.751)
ALT	0.128 (p=0.040)	−0.041 (p=0.612)
AST	0.263 (p<0.001)	−0.053 (p=0.516)
TG	0.031 (p=0.620)	0.029 (p=0.722)
Serum Cholesterol	0.155 (p=0.013)	−0.006 (p=0.945)
HDL	−0.224 (p<0.001)	−0.160 (p=0.046)
LDL	−0.060 (p=0.341)	−0.131 (p=0.105)
Serum Creatinine	0.066 (p=0.295)	0.107 (p=0.186)

Note: Data presented as Spearman correlation coefficient (its p value).

Figure 1 Box-and-whisker plot chart showing difference between groups regarding: (A) serum proneurotensin, (B) serum micro-RNA-122.

Table 4 Cut off Value of Pro-Neurotensin and microRNA 122 in Diagnosis of NAFLD

	Cut-off	Sensitivity (%)	Specificity (%)	PPV	NPV
Serum Proneurotensin (pmol/L)	≥ 108	80.0%	80.0%	86.1%	72.2%
Micro-RNA 122	≥ 6.83	51.0%	70.0%	72.5%	47.9%

Abbreviations: PPV, positive predictive value; NPV, negative predictive value.

Figure 2 ROC curve for diagnosis of pro-neurotensin and microRNA 122 assay in NAFLD patients.