Abstract: Objective To investigate the potential value of serum FABP4 level and some laboratory indicators in classification and prognosis of DILI. Methods DILI patients, admitted to the Department of Infectious Diseases, Ruijin Hospital, from January 2016 to December 2017, were enrolled. History data, laboratory indicators, and serum within 14 days of onset were collected. The expression of FABP4 was compared among different clinical classifications and outcomes, respectively. Kendall correlation analysis was performed on various clinical data, laboratory indicators and clinical outcomes. Results One hundred and fifty-eight patients, including 111 females, had different types of liver injury: hepatocellular injury (50.0%, 79/158), mixed injury (17.1%, 27/158) and cholestatic injury (32.9%, 52/158). According to clinical outcomes, patients were divided into three groups, including 100 of recovery within 6 months (63.3%), 42 of chronicity (26.6%) and 16 of liver transplantation or death due to DILI (10.1%). Furthermore, serum FABP4 levels in patients with different types of liver injury were 9.83±1.40 ng/mL (hepatocellular injury), 12.70±1.42 ng/mL (mixed injury) and 23.05±3.48 ng/mL (cholestasic injury), respectively. Serum FABP4 level was significantly increased in chronic patients (14.47±1.67 ng/mL) compared with patients who recovered within 6 months (11.58±1.31 ng/mL). It was also notably higher in death/liver transplantation group (36.18±10.07 ng/mL) than the other two groups. Conclusion Serum FABP4 was significantly increased in the cholestasis DILI and death/liver transplantation groups, which was significantly associated with ALT, total bilirubin, outcome and clinical injury type. Serum FABP4 level might be a valuable factor in the prognosis of DILI to some extent.

Key words: Fatty acid binding protein 4, Drug-induced liver injury, Cholestasis, Chronic DILI