Procalcitonin as a Predictive Marker of Incident Liver Disease
(2025) In Liver International 45(6).- Abstract
Background and Aims: Previous studies have shown that procalcitonin (PCT) concentration is elevated in patients with liver disease without evidence of bacterial infection. We aimed to investigate the association between elevated PCT and the future risk of liver disease. Method: PCT was measured in 3897 individuals without known liver disease in the Malmö Diet and Cancer Cardiovascular Cohort (MDC-CC) and in 3854 individuals in the Malmö Preventive Project cohort (MPP). Cox proportional hazards regression models were used to analyse the risk of register-verified incident liver disease by PCT levels. We performed our analyses in a pooled sample of both the MPP and MDC-CC cohorts, as well as separate analyses for each cohort. Results: 70... (More)
Background and Aims: Previous studies have shown that procalcitonin (PCT) concentration is elevated in patients with liver disease without evidence of bacterial infection. We aimed to investigate the association between elevated PCT and the future risk of liver disease. Method: PCT was measured in 3897 individuals without known liver disease in the Malmö Diet and Cancer Cardiovascular Cohort (MDC-CC) and in 3854 individuals in the Malmö Preventive Project cohort (MPP). Cox proportional hazards regression models were used to analyse the risk of register-verified incident liver disease by PCT levels. We performed our analyses in a pooled sample of both the MPP and MDC-CC cohorts, as well as separate analyses for each cohort. Results: 70 subjects in MDC-CC and 49 subjects in MPP were diagnosed with non-viral liver disease during a median follow-up of 27.1 and 14.8 years, respectively. In multivariate adjusted models in the pooled sample, individuals with high PCT (> 0.05 ng/mL) had a significantly increased risk of developing liver disease compared to subjects with PCT concentrations below the cutoff (hazard ratio (HR) 3.4, 95% confidence interval (CI) 2.07–5.63, p < 0.001). The HR per standard deviation increase of log-transformed PCT was 1.56 (95% CI 1.32–1.85, p < 0.001) in multivariate adjusted models. Separate cohort-specific sensitivity analyses, including additional adjustment for C-reactive protein, showed similar effect estimates as the pooled analyses. Conclusions: Elevated concentration of PCT independently predicts non-viral liver disease. These findings could have implications for risk assessment but also highlight the possibility of PCT as a direct cause of hepatocyte damage.
(Less)
- author
- Finnberg-Kim, Amanda
LU
; Pihlsgård, Mats
LU
; Önnerhag, Kristina
LU
; Melander, Olle
LU
and Enhörning, Sofia LU
- organization
-
- Gastroenterology (research group)
- Perinatal and cardiovascular epidemiology (research group)
- EXODIAB: Excellence of Diabetes Research in Sweden
- Cardiovascular Research - Hypertension (research group)
- EpiHealth: Epidemiology for Health
- MultiPark: Multidisciplinary research focused on Parkinson's disease
- publishing date
- 2025-06
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- C-reactive protein, liver cirrhosis, liver disease, procalcitonin, risk assessment
- in
- Liver International
- volume
- 45
- issue
- 6
- article number
- e70132
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:40353301
- scopus:105005234109
- ISSN
- 1478-3223
- DOI
- 10.1111/liv.70132
- language
- English
- LU publication?
- yes
- id
- 407ebfc2-6a35-4090-9b42-fb38d6a11e88
- date added to LUP
- 2025-07-29 11:08:43
- date last changed
- 2025-07-30 03:00:03
@article{407ebfc2-6a35-4090-9b42-fb38d6a11e88, abstract = {{<p>Background and Aims: Previous studies have shown that procalcitonin (PCT) concentration is elevated in patients with liver disease without evidence of bacterial infection. We aimed to investigate the association between elevated PCT and the future risk of liver disease. Method: PCT was measured in 3897 individuals without known liver disease in the Malmö Diet and Cancer Cardiovascular Cohort (MDC-CC) and in 3854 individuals in the Malmö Preventive Project cohort (MPP). Cox proportional hazards regression models were used to analyse the risk of register-verified incident liver disease by PCT levels. We performed our analyses in a pooled sample of both the MPP and MDC-CC cohorts, as well as separate analyses for each cohort. Results: 70 subjects in MDC-CC and 49 subjects in MPP were diagnosed with non-viral liver disease during a median follow-up of 27.1 and 14.8 years, respectively. In multivariate adjusted models in the pooled sample, individuals with high PCT (> 0.05 ng/mL) had a significantly increased risk of developing liver disease compared to subjects with PCT concentrations below the cutoff (hazard ratio (HR) 3.4, 95% confidence interval (CI) 2.07–5.63, p < 0.001). The HR per standard deviation increase of log-transformed PCT was 1.56 (95% CI 1.32–1.85, p < 0.001) in multivariate adjusted models. Separate cohort-specific sensitivity analyses, including additional adjustment for C-reactive protein, showed similar effect estimates as the pooled analyses. Conclusions: Elevated concentration of PCT independently predicts non-viral liver disease. These findings could have implications for risk assessment but also highlight the possibility of PCT as a direct cause of hepatocyte damage.</p>}}, author = {{Finnberg-Kim, Amanda and Pihlsgård, Mats and Önnerhag, Kristina and Melander, Olle and Enhörning, Sofia}}, issn = {{1478-3223}}, keywords = {{C-reactive protein; liver cirrhosis; liver disease; procalcitonin; risk assessment}}, language = {{eng}}, number = {{6}}, publisher = {{Wiley-Blackwell}}, series = {{Liver International}}, title = {{Procalcitonin as a Predictive Marker of Incident Liver Disease}}, url = {{http://dx.doi.org/10.1111/liv.70132}}, doi = {{10.1111/liv.70132}}, volume = {{45}}, year = {{2025}}, }