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Procalcitonin as a Predictive Marker of Incident Liver Disease

Finnberg-Kim, Amanda LU ; Pihlsgård, Mats LU ; Önnerhag, Kristina LU ; Melander, Olle LU orcid and Enhörning, Sofia LU (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.

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author
; ; ; and
organization
publishing date
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 (&gt; 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 &lt; 0.001). The HR per standard deviation increase of log-transformed PCT was 1.56 (95% CI 1.32–1.85, p &lt; 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}},
}