Role of serum liver markers and elastography in liver fibrosis evaluation depending on body weight
Drug-induced liver injury (DILI) represents a significant yet often underestimated challenge in contemporary medicine, exerting a pivotal influence on the landscape of liver pathology. Acknowledging that official statistics fall short of capturing the genuine prevalence of DILI due to inherent underreporting, this article addresses the issue through a study concentrating on serum liver fibrosis markers among female breast cancer patients subjected to polychemotherapy. The research endeavors to scrutinize the prognostic significance of serum liver fibrosis markers. Additionally, the study investigates correlations among direct fibrosis markers in patients with diverse body weight statuses. The cohort, comprising 123 females, underwent categorization based on the severity of DILI post-polychemotherapy. Employing universal clinically significant indicators, specifically fibrosis indices (FIB-4, Fibrotest), the study comprehensively evaluated liver parenchymal damage using biochemical markers two months post-treatment. Results unveiled a positive correlation between TGF-β1 and Col-4 fibrosis markers and body mass index (BMI). With increasing BMI, levels of TGF-β1 and Col-4 escalated, notably exhibiting a 2.2 and 1.2 times increase, respectively, in obese individuals compared to those with normal weight. Furthermore, heightened TGF-β1 and Col-4 levels correlated with advanced fibrosis stages based on average Fibrotest and FIB-4 index values (r=0.720, p<0.05 and r=0.716, p<0.05) and (r=0.771, p<0.05 and r=0.799, p<0.05). These findings propose a potential link between stellate cell activation, necroinflammatory fibrosis, and type IV collagen expression initiation. Remarkably, TGF-β1 and Col-4 emerge as prospective markers for monitoring fibrosis progression in DILI post-chemotherapy, providing avenues for refined diagnosis and treatment strategies.