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Microfibrillar-Associated Protein 4: A Potential Biomarker for Screening for Liver Fibrosis in a Mixed Patient Cohort
Susanne Gjørup Sækmose1, Belinda Mössner2, Peer Brehm Christensen2
1Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark.
Background And Aims:
A method for assessment of liver fibrosis and cirrhosis without the need for a liver biopsy is desirable. Microfibrillar-associated protein 4 (MFAP4) is a suggested biomarker for identification of high-risk patients with severe fibrosis stages. This study aimed to examine associations between plasma MFAP4 (pMFAP4) and transient elastography or chronic hepatitis C virus infection in drug users and in a mixed patient cohort with increased risk of liver disease. Moreover, the study aimed to identify comorbidities that significantly influence pMFAP4.
Methods:
pMFAP4 was measured in samples from 351 drug users attending treatment centres and from 248 acutely hospitalized medical patients with mixed diagnoses. Linear and logistic multivariate regression analyses were performed and nonparametric receiver operating characteristic-curves for cirrhosis were used to estimate cut-off points for pMFAP4. Univariate and subgroup analyses were performed using non-parametric methods.
Results:
pMFAP4 increased significantly with liver fibrosis score. pMFAP4 was significantly associated with chronic viral infection in the drug users and with transient elastography in both cohorts. In the mixed patient cohort, pMFAP4 was significantly increased among patients with a previous diagnosis of liver disease or congestive heart failure compared to patients with other diagnoses.
Conclusions:
pMFAP4 has the potential to be used as an outreach-screening tool for liver fibrosis in drug users and in mixed medical patients. pMFAP4 level is positively associated with transient elastography, but additional studies are warranted to validate the possible use of pMFAP4 in larger cohorts and in combination with transient elastography.
Insights
Plasma MFAP4 shows potential as a non-invasive biomarker for liver fibrosis screening in drug users and medical patients. It correlates with liver stiffness and viral hepatitis, aiding early detection of liver disease.
Area of Science:
- Biomarker discovery
- Hepatology
- Clinical diagnostics
Background:
- Liver biopsy is invasive; non-invasive methods for assessing liver fibrosis are needed.
- Microfibrillar-associated protein 4 (MFAP4) is a potential biomarker for severe fibrosis.
- This study investigates plasma MFAP4 (pMFAP4) in relation to liver disease markers and comorbidities.
Purpose of the Study:
- To assess the association between pMFAP4 and liver fibrosis/cirrhosis.
- To evaluate pMFAP4 as a screening tool in drug users and mixed patient cohorts.
- To identify comorbidities influencing pMFAP4 levels.
Main Methods:
- pMFAP4 measured in 351 drug users and 248 mixed medical patients.
- Multivariate regression analyses and ROC curves used for assessment.
- Non-parametric methods applied for univariate and subgroup analyses.
Main Results:
- pMFAP4 levels significantly correlated with liver fibrosis scores.
- pMFAP4 associated with chronic viral infection and transient elastography in both cohorts.
- Increased pMFAP4 observed in patients with prior liver disease or heart failure.
Conclusions:
- pMFAP4 demonstrates potential as an outreach screening tool for liver fibrosis.
- pMFAP4 is positively associated with transient elastography.
- Further validation in larger cohorts and combination studies are recommended.
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