{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T17:51:51Z","timestamp":1780336311038,"version":"3.54.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T00:00:00Z","timestamp":1666224000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Alcohol\u2010associated liver fibrosis accumulates over decades, driven by hepatic inflammation and cell death. We investigated the diagnostic accuracy of keratin\u201018 degradation, measured using serum M30 and M65 levels, and the ActiTest for hepatic inflammatory activity in patients with compensated alcohol\u2010associated liver disease (ALD). Furthermore, we evaluated the prognostic accuracy of markers for liver\u2010related events and all\u2010cause mortality. All findings were compared with routine liver function tests: Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma\u2010glutamyltransferase. Our prospective, biopsy\u2010controlled, single\u2010center study included 265 patients with ongoing or prior excessive alcohol intake, representing the full spectrum of compensated ALD. We defined hepatic inflammatory activity as a combined score of lobular inflammation and ballooning. For severe hepatic inflammatory activity (n\u00a0=\u00a040), we found excellent diagnostic accuracy for M30 (area under the receiver operating characteristics curve [AUROC]\u00a0=\u00a00.90), M65 (AUROC\u00a0=\u00a00.86), and AST (AUROC\u00a0=\u00a00.86). Elevated M30 (M30\u2009&gt;\u2009240\u2009U\/L) had the highest positive predictive value (PPV) and specificity, significantly higher than M65, ActiTest and ALT, but not AST (M30: sensitivity\u00a0=\u00a083%, specificity\u00a0=\u00a082%, positive predictive value\u00a0=\u00a045%, negative predictive value\u00a0=\u00a095%). Patients were followed up for 1445 patient\u2010years. All markers, except for ALT, significantly predicted liver\u2010related events and all\u2010cause mortality. After adjusting for advanced fibrosis, drinking behavior and body mass index, M30 and M65 remained significant predictors of liver\u2010related events, whereas M30 and AST were significant predictors of all\u2010cause mortality. <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>: M30 and AST accurately detect severe hepatic inflammatory activity in patients with compensated ALD. M30 was the only significant predictor of both liver\u2010related events and all\u2010cause mortality after adjusting for advanced fibrosis, body mass index, and drinking behavior at inclusion.<\/jats:p>","DOI":"10.1002\/hep4.2075","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T13:39:28Z","timestamp":1666273168000},"page":"3421-3432","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["Serum keratin\u201018 detects hepatic inflammation and predicts progression in compensated alcohol\u2010associated liver disease"],"prefix":"10.1097","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0411-0373","authenticated-orcid":false,"given":"Katrine Holtz","family":"Thorhauge","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology,Odense University Hospital,Odense,Denmark"},{"name":"Institute for Clinical Research,University of Southern 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Hepatology,Odense University Hospital,Odense,Denmark"},{"name":"Institute for Clinical Research,University of Southern Denmark,Odense,Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5031-2294","authenticated-orcid":false,"given":"Stine","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology,Odense University Hospital,Odense,Denmark"},{"name":"Institute for Clinical Research,University of Southern Denmark,Odense,Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2846-3598","authenticated-orcid":false,"given":"Bj\u00f8rn St\u00e6hr","family":"Madsen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology,Odense University Hospital,Odense,Denmark"},{"name":"Institute for Clinical Research,University of Southern Denmark,Odense,Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steen","family":"Antonsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry,Odense University Hospital,Svendborg,Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars Melholt","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Institute for Clinical Research,University of Southern Denmark,Odense,Denmark"},{"name":"Department of Clinical Biochemistry and Pharmacology,Odense University Hospital,Odense,Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7891-7706","authenticated-orcid":false,"given":"Katrine Prier","family":"Lindvig","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology,Odense University Hospital,Odense,Denmark"},{"name":"Institute for Clinical Research,University of Southern 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