High serum N-terminal propeptide of procollagen type III concentration is associated with liver diseases

Introduction: N-terminal propeptide of procollagen type III (PIIINP) is generated during the synthesis of type III collagen. PIIINP can be measured in the serum as an indicator of liver fibrosis and cirrhosis.

Aim: To evaluate the effect of liver diseases of different aetiologies and clinical severity of liver cirrhosis on the serum level of PIIINP.

Material and methods: Patients with alcoholic cirrhosis (AC) – 63 subjects, non-alcoholic cirrhosis (NAC) – 31 and toxic hepatitis (HT) – 33 were studied. Cirrhotic patients were classified according to the Child-Pugh scale. The samples were analysed using the ELISA method.

Results: The level of PIIINP was significantly higher in patients with alcoholic cirrhosis, non-alcoholic cirrhosis, and toxic hepatitis in comparison to the control group. There were no significant differences in the serum PIIINP levels between liver diseases and according to the severity of liver cirrhosis. PIIINP has the highest diagnostic power for the diagnosis of toxic hepatitis. The highest sensitivity was reached in alcoholic cirrhosis, but other diagnostic values (specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy (ACC)) in alcoholic cirrhosis were lower than that in toxic hepatitis. In the diagnosis of non-alcoholic cirrhosis PIIINP has low sensitivity, specificity, PPV, NPV, and ACC.

Conclusions: The serum PIIINP shows the alterations in liver diseases in comparison to healthy controls, but not between diseases. Taking the above into account we can suggest that PIIINP may be a useful test for the detection of liver diseases.