Background: Increased fucosylation of serum glycoproteins has previously been reported in patients with liver disease. We analyzed α1-acid glycoprotein (AGP) fucosylation in serum samples from patients investigated for suspected liver disease, in order to evaluate its value as a biochemical marker for liver cirrhosis.
Methods: We used a novel lectin innnunoassay adapted to the Auto-DELFIA system to analyze AGP fucosylation in 261 consecutive patients admitted for liver biopsy at Malmö university hospital in Southern Sweden. The results were compared with histopathological findings. In addition, AGP fucosylation was compared to other biochemical markers described to be useful in the diagnosis of liver cirrhosis. The different biochemical markers were compared by ROC curve analysis.
Results: AGP fucosylation was significantly higher in patients with liver cirrhosis (n=65) than in nmmal controls (n=72), patients with normal histology (n=29), patients with steatosis only (n=38), patients with viral or chronic hepatitis without ciiThosis (n=71), and patients with other liver diseases without histological signs of cirrhosis (n=58). By calculating an AGP fucosylation index (AGP-FI = AGP fucosylation/AGP serum concentration), a high diagnostic accuracy was obtained. The area under the curve for AGP-FI was 0.83 and 0.74 for men and women respectively, compared to 0.82 for hyaluronic acid, and 0.77 for AST/ALT ratio in both men and women.
Conclusion: We conclude that AGP fucosylation appears to be useful in identifying patients with liver cirrhosis among patients investigated for liver disease. The lectin immunoassay showed satisfactory reproducibility, and is suitable for routine use in a clinical laboratory.