Elevated alpha-fetoprotein in asymptomatic adults: Clinical features, outcome, and association with body composition.
<h4>Background and aim</h4>Apparently healthy individuals with elevated serum alpha-fetoprotein (AFP) levels (>7 ng/mL) for unknown causes visit clinics. We investigated their clinical characteristics, outcomes, and relationship with body fat deposition and muscle mass.<h4>Metho...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0271407 |
| _version_ | 1818041240105517056 |
|---|---|
| author | Sangmi Jang Gwang Hyeon Choi Won Chang Eun Sun Jang Jin-Wook Kim Sook-Hyang Jeong |
| author_facet | Sangmi Jang Gwang Hyeon Choi Won Chang Eun Sun Jang Jin-Wook Kim Sook-Hyang Jeong |
| author_sort | Sangmi Jang |
| collection | DOAJ |
| description | <h4>Background and aim</h4>Apparently healthy individuals with elevated serum alpha-fetoprotein (AFP) levels (>7 ng/mL) for unknown causes visit clinics. We investigated their clinical characteristics, outcomes, and relationship with body fat deposition and muscle mass.<h4>Methods</h4>The case group included asymptomatic 137 individuals with "elevated AFP level" (R772) diagnostic code from 2009 to 2018 in a tertiary hospital. The control group enrolled 274 age- and sex-matched patients with <5 cm hepatic hemangiomas. Hepatic, visceral, and psoas muscle adiposity and psoas muscle index (PMI) were measured in the subgroups of 45 cases and 90 controls with pre-contrast computed tomography (CT) images.<h4>Results</h4>The case group (mean age 47.5 years, male 35.8%) showed higher AFP levels (10.3 vs 2.5 ng/mL, p<0.001) and total bilirubin (0.8 vs 0.7 mg/dL, p<0.001), but a lower body mass index (22.2 vs 23.3 kg/m2, p = 0.011) and alanine aminotransferase levels (17.0 vs 19.0 IU/L, p = 0.047) than the controls. During 13 months of median follow-up, there was no cancer or liver disease development. The AFP levels were stable. In the subgroups with CT images, cases showed a lower proportion of hepatic steatosis (4.4% vs 18.9%, p = 0.023), higher psoas muscle attenuation (48.2 vs 43.8 Hounsfield units, p<0.001) and higher PMI (5.7 vs 4.2 cm2/m2, p<0.001) than the controls.<h4>Conclusion</h4>Elevated AFP levels in asymptomatic individuals may play a role in expressing a protective phenotype against hepatic steatosis, myosteatosis, and sarcopenia. AFP levels in patients with elevated AFP were stable during follow-up without liver injury or cancer development. Interaction between AFP expression and steatosis warrants further study. |
| first_indexed | 2024-12-10T08:27:16Z |
| format | Article |
| id | doaj.art-88c29424314c4669888d16d9f64bc25f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T08:27:16Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-88c29424314c4669888d16d9f64bc25f2022-12-22T01:56:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01177e027140710.1371/journal.pone.0271407Elevated alpha-fetoprotein in asymptomatic adults: Clinical features, outcome, and association with body composition.Sangmi JangGwang Hyeon ChoiWon ChangEun Sun JangJin-Wook KimSook-Hyang Jeong<h4>Background and aim</h4>Apparently healthy individuals with elevated serum alpha-fetoprotein (AFP) levels (>7 ng/mL) for unknown causes visit clinics. We investigated their clinical characteristics, outcomes, and relationship with body fat deposition and muscle mass.<h4>Methods</h4>The case group included asymptomatic 137 individuals with "elevated AFP level" (R772) diagnostic code from 2009 to 2018 in a tertiary hospital. The control group enrolled 274 age- and sex-matched patients with <5 cm hepatic hemangiomas. Hepatic, visceral, and psoas muscle adiposity and psoas muscle index (PMI) were measured in the subgroups of 45 cases and 90 controls with pre-contrast computed tomography (CT) images.<h4>Results</h4>The case group (mean age 47.5 years, male 35.8%) showed higher AFP levels (10.3 vs 2.5 ng/mL, p<0.001) and total bilirubin (0.8 vs 0.7 mg/dL, p<0.001), but a lower body mass index (22.2 vs 23.3 kg/m2, p = 0.011) and alanine aminotransferase levels (17.0 vs 19.0 IU/L, p = 0.047) than the controls. During 13 months of median follow-up, there was no cancer or liver disease development. The AFP levels were stable. In the subgroups with CT images, cases showed a lower proportion of hepatic steatosis (4.4% vs 18.9%, p = 0.023), higher psoas muscle attenuation (48.2 vs 43.8 Hounsfield units, p<0.001) and higher PMI (5.7 vs 4.2 cm2/m2, p<0.001) than the controls.<h4>Conclusion</h4>Elevated AFP levels in asymptomatic individuals may play a role in expressing a protective phenotype against hepatic steatosis, myosteatosis, and sarcopenia. AFP levels in patients with elevated AFP were stable during follow-up without liver injury or cancer development. Interaction between AFP expression and steatosis warrants further study.https://doi.org/10.1371/journal.pone.0271407 |
| spellingShingle | Sangmi Jang Gwang Hyeon Choi Won Chang Eun Sun Jang Jin-Wook Kim Sook-Hyang Jeong Elevated alpha-fetoprotein in asymptomatic adults: Clinical features, outcome, and association with body composition. PLoS ONE |
| title | Elevated alpha-fetoprotein in asymptomatic adults: Clinical features, outcome, and association with body composition. |
| title_full | Elevated alpha-fetoprotein in asymptomatic adults: Clinical features, outcome, and association with body composition. |
| title_fullStr | Elevated alpha-fetoprotein in asymptomatic adults: Clinical features, outcome, and association with body composition. |
| title_full_unstemmed | Elevated alpha-fetoprotein in asymptomatic adults: Clinical features, outcome, and association with body composition. |
| title_short | Elevated alpha-fetoprotein in asymptomatic adults: Clinical features, outcome, and association with body composition. |
| title_sort | elevated alpha fetoprotein in asymptomatic adults clinical features outcome and association with body composition |
| url | https://doi.org/10.1371/journal.pone.0271407 |
| work_keys_str_mv | AT sangmijang elevatedalphafetoproteininasymptomaticadultsclinicalfeaturesoutcomeandassociationwithbodycomposition AT gwanghyeonchoi elevatedalphafetoproteininasymptomaticadultsclinicalfeaturesoutcomeandassociationwithbodycomposition AT wonchang elevatedalphafetoproteininasymptomaticadultsclinicalfeaturesoutcomeandassociationwithbodycomposition AT eunsunjang elevatedalphafetoproteininasymptomaticadultsclinicalfeaturesoutcomeandassociationwithbodycomposition AT jinwookkim elevatedalphafetoproteininasymptomaticadultsclinicalfeaturesoutcomeandassociationwithbodycomposition AT sookhyangjeong elevatedalphafetoproteininasymptomaticadultsclinicalfeaturesoutcomeandassociationwithbodycomposition |