Serum soluble urokinase plasminogen activator receptor in alcoholics: Relation to liver disease severity, fibrogenesis, and alcohol use

Background and Aim: Heavy alcohol consumption may lead to development of liver disease and the need for non-invasive parameters for detecting those at risk is widely acknowledged. Methods: We measured serum soluble urokinase-type plasminogen activator receptor (suPAR) levels from 63 patients with alcoholic liver disease (ALD), 57 heavy drinkers without apparent liver disease, and 39 controls who were either moderate drinkers or abstainers. Results: The highest serum suPAR concentrations were detected in patients with ALD (P < 0.001) showing high diagnostic accuracy in differentiating ALD patients from heavy drinkers without liver disease (area under curve 0.921, P < 0.001). Levels of suPAR correlated positively with serum markers of fibrogenesis (aminoterminal propeptide of type III procollagen and hyaluronic acid) (P < 0.001), with clinical (combined clinical and laboratory index P < 0.01) and morphological (combined morphological index P < 0.05) indices of liver disease severity and with the stage of fibrosis (P < 0.01). The suPAR concentrations were also elevated in heavy drinkers when compared with healthy controls (P < 0.001). Conclusion: The data indicate that serum suPAR concentrations are increased as a result of heavy alcohol consumption and further with development of ALD, showing a good diagnostic performance in detecting those with liver disease. The association with the histological severity of ALD and correlation with fibrosis indicates potential of serum suPAR also as a prognostic marker in ALD.