# Platelet-derived growth factor receptor-β as a non-invasive biomarker for liver fibrosis prediction in Egyptian diabetic patients with metabolic-associated fatty liver disease

## TL;DR

This study shows that PDGFRβ is a promising non-invasive biomarker for predicting liver fibrosis in Egyptian diabetic patients with fatty liver disease.

## Contribution

The study introduces PDGFRβ as a novel, effective non-invasive biomarker for liver fibrosis in diabetic MAFLD patients.

## Key findings

- PDGFRβ levels were significantly higher in diabetic and nondiabetic MAFLD patients compared to healthy controls.
- PDGFRβ at a cutoff > 2.54 achieved 85% sensitivity and 93.33% specificity for predicting significant liver fibrosis in diabetic MAFLD patients.
- Combining PDGFRβ and FIB-4 achieved 100% accuracy in predicting significant liver fibrosis in diabetic MAFLD patients.

## Abstract

Circulating platelet-derived growth factor receptor-β (PDGFRβ) has recently been found to correlate with severity of liver disease in multiple etiologies, including liver steatosis. In diabetic patients with metabolic-associated fatty liver disease (MAFLD), widely used non-invasive scoring systems, particularly the fibrosis-4 (FIB-4) score, showed unsatisfactory performance in predicting liver fibrosis severity. The aim of this study was to evaluate the productivity of serum PDGFRβ as a non-invasive biomarker of liver fibrosis in diabetic MAFLD patients.

This was a population-based case-control study conducted on 50 diabetic MAFLD patients, 40 nondiabetic MAFLD patients, and 40 healthy controls. All subjects underwent complete history taking, clinical examination, anthropometric measurements, bioelectrical impedance analysis (BIA), and laboratory tests, including the PDGFRβ assay. Hepatic steatosis was assessed with magnetic resonance imaging (MRI), along with magnetic resonance elastography (MRE) for the assessment of liver fibrosis. The diagnostic performance of PDGFRβ as well as PDGFRβ + FIB-4 in prediction of significant liver fibrosis in diabetic MAFLD patients was assessed.

Liver steatosis and significant liver fibrosis (≥ F2) were significantly higher in diabetic MAFLD patients than in nondiabetics. PDGFRβ levels were significantly higher in both diabetic and nondiabetic MAFLD patients compared to controls. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PDGFRβ to predict significant liver fibrosis in diabetic MAFLD patients were 85%, 93.33%, 89.5%, and 90.3%, respectively, at a cutoff > 2.54, and were 85.71%, 51.52%, 27.3%, and 94.4% at a cutoff > 1.59 in nondiabetics. Sensitivity, specificity, PPV, and NPV of (PDGFRβ at a cutoff > 2.54 + FIB-4 at a cutoff > 1.17) to predict significant liver fibrosis in diabetic MAFLD patients were 100%. PDGFRβ was the only independent predictor of significant liver fibrosis in diabetic MAFLD (p = 0.006).

PDGFRβ proved efficacy as a noninvasive biomarker in the prediction of significant liver fibrosis (≥ F2) in diabetic MAFLD patients.