PIVKA‑II is associated with liver function, bone metabolism, and muscle function in patients with liver disease

Honda,Takuya; Ichikawa,Tatsuki; Yamashima,Mio; Yamamichi,Shinobu; Koike,Makiko; Nakano,Yusuke; Honda,Tetsurou; Yajima,Hiroyuki; Miyazaki,Osamu; Kuribayashi,Yasutaka; Ikeda,Tomonari; Okamura,Takuma; Nagata,Kazuyoshi; Nakao,Kazuhiko

doi:10.3892/br.2023.1690

PIVKA‑II is associated with liver function, bone metabolism, and muscle function in patients with liver disease

Authors:
- Takuya Honda
- Tatsuki Ichikawa
- Mio Yamashima
- Shinobu Yamamichi
- Makiko Koike
- Yusuke Nakano
- Tetsurou Honda
- Hiroyuki Yajima
- Osamu Miyazaki
- Yasutaka Kuribayashi
- Tomonari Ikeda
- Takuma Okamura
- Kazuyoshi Nagata
- Kazuhiko Nakao
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Affiliations: Clinical Oncology Center, Nagasaki University Hospital, Nagasaki 852‑8501, Japan, Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850‑8555, Japan, Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Nagasaki 850‑8555, Japan, Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852‑8501, Japan
Published online on: November 13, 2023 https://doi.org/10.3892/br.2023.1690
Article Number: 2
Copyright: © Honda et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Protein induced by vitamin K (VK) absence‑II (PIVKA‑II) is a sensitive marker for diagnosing hepatoma but is occasionally detected in patients without hepatoma Here, the clinical significance of serum PIVKA‑II levels in patients who were not administered warfarin and did not have hepatoma or liver disease were evaluated. As VK is related to muscle and bone metabolism, PIVKA‑II and clinical factors related to bone and muscle were compared. A total of 441 patients with various liver diseases were evaluated. Of these, 236 patients were female. Clinical factors and anthropometric measurements were obtained for each participant during outpatient visits. Among the clinical factors, type I procollagen N‑propeptide (P1NP), a low titer of undercarboxylated osteocalcin (ucOC), and 25(OH) vitamin D (VD) were used as bone metabolic markers, and SARC‑F and grip strength were used as muscle‑related markers. Serum PIVKA‑II levels above the upper limit were associated with Child B/C (Child‑Pugh score), high titers of total P1NP, and low titers of ucOC in females, and alcohol‑related liver disease and low VD in males. The titer of PIVKA‑II were associated with immunoglobulin (Ig) A and prothrombin time (PT)‑international normalized ratio (INR) in females, and fibrosis‑4‑4, IgG, total bilirubin, PT‑INR, and SARC‑F in males. Elevated PIVKA‑II levels were associated with abnormal bone physiology in females, weak muscles in males, and severe liver disease in both sexes. Assessing PIVKA‑II may assist in evaluating the clinical and bone‑muscle metabolic stages in liver disease. Nutrition and supplementation with fat‑soluble vitamins, including VK and VD may thus serve as a potential method to alleviate or prevent bone‑muscle pathophysiology in patients with liver disease.

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