Liver Fatty Acid Binding Protein: Is it an early diagnostic and prognostic marker in liver damage?

Objective: The majority of the liver function tests are not specific to the liver. The histological liver damage begins before patients are diagnosed with cirrhosis and continues afterwards. Therefore, there is an increasing demand for early and specific markers that are correlated with liver damage. This study aims to investigate if serum and urinary liver fatty acid-binding protein (L-FABP) levels could be used as an early diagnostic marker of liver cirrhosis. Material and Methods: This cross-sectional study included 30 patients with compensated liver cirrhosis, 27 patients with decompensated liver cirrhosis, and 30 healthy controls. The patients and healthy controls were tested for serum and urinary L-FABP levels. Results: The serum and urinary L-FABP levels were higher in patients with cirrhosis than the healthy controls (both p<0.001). The cut-off value of serum and urinary L-FABP was computed as 721.78 ng/ml and 621.25 ng/ml, respectively. The sensitivity of serum and urinary L-FABP to detect cirrhosis at this cut-off was 99.8% and 98.9%. The specificity, positive predictive value, and negative predictive value of serum and urinary L-FABP at these cut-off levels were 100 %. There was no difference in terms of serum and urinary L-FABP between compensated and decompensated cirrhosis patients. Accordingly, no correlation was determined between serum/urinary L-FABP levels and cirrhosis complications. Conclusion: L-FABP increases in serum and urine in response to hepatocyte damage that can result in liver fibrosis. We demonstrated that patients with liver cirrhosis had high L-FABP levels. L-FABP may be used as a predictive non-invasive marker of cirrhosis as it can be detected before the clinical symptoms of liver damage.