Associations among serum levels of MMP-1, MMP-2, and METAVIR fibrosis score in patients with nonalcoholic fatty liver disease.

AIM: We evaluated their diagnostic potential compared to histopathology and standard biochemical tests of liver function. BACKGROUND: Liver fibrosis is considered a reversible condition, making early diagnosis essential. Serum levels of matrix metalloproteinase (MMP) -1 and MMP-2 are investigated as parameters for diagnosing fibrosis in chronic liver disease. METHODS: Commercially available ELISA assays were used to study serum levels of MMP-1 and MMP-2 in 50 patients with nonalcoholic fatty liver disease (NAFLD). Fibrosis stages were evaluated using the METAVIR scoring system. Spearman's coefficient analysed correlations of serum levels of MMP-1, MMP-2, and liver biopsy score, and specificity and sensitivity were calculated through receiver operating characteristic (ROC) analysis. RESULTS: MMP-1 levels in fibrosis stage F1 (14.20±3.10 ng/mL) were not significantly different from stage F2 (9.26±2.21 ng/mL) but were higher (p<0.001) than F3 (7.15±1.56 ng/mL) and F4 (4.53±0.62 ng/mL). MMP-2 levels in F1 (68.57±8.22 ng/mL) were similar to F2 (76.31±9.25 ng/mL) but lower (p<0.001) than F3 (103.34±17.59 ng/mL) and F4 (214.24±46.72 ng/mL). Significant differences were seen between mild fibrosis (F1-2) and severe fibrosis/cirrhosis (F3-4) for MMP-1 (p<0.01) and MMP-2 (p<0.001). Correlation analysis revealed a weak inverse correlation for MMP-1 (r=-0.383, p<0.01) and a weak direct correlation for MMP-2 (r=0.392, p<0.01) with fibrosis stages. MMP-2 levels >86.78 ng/mL had a sensitivity of 73.7% and specificity of 61.3% for fibrosis detection, while MMP-1 levels <4.96 ng/mL had a sensitivity of 52.6% and specificity of 32.3%. Using ROC analysis, MMP-2 had significant diagnostic ability in detecting liver fibrosis stages (area under the curve 0.722, p<0.01). CONCLUSION: Serum levels of MMP-2 are able to detect liver fibrosis. Despite the limited sample size, these findings support further investigation and potential integration of MMP-2 testing into routine clinical practice.