Metabolic Dysfunction-Associated Steatotic Liver Disease in Severe Obesity and Concordance between Invasive (Biopsy) and Noninvasive (OWLiver®) Diagnoses.

IF 3.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Obesity Facts Pub Date : 2024-01-01 Epub Date: 2024-06-26 DOI:10.1159/000538765

Èlia Navarro-Masip, Nuria Mestres Petit, Blanca Salinas-Roca, Fernando Herrerías, Felip Vilardell, Mari Cruz de la Fuente, Judit Pallares, Maite Santamaría, Marta Zorzano-Martínez, Enric Sánchez, Xavier Matías-Guiu, Carolina López-Cano, Ana Gloria Soler, Josep León-Mengíbar, Marta Bueno, Albert Lecube

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Abstract

Introduction: Nonalcoholic fatty liver disease (NAFLD), now termed metabolic dysfunction-associated steatotic liver disease (MASLD), is an escalating health concern linked to obesity and type 2 diabetes. Despite liver biopsy being the gold standard, its invasiveness underscores the need for noninvasive diagnostic methods.

Methods: A cross-sectional study was performed to assess MASLD using the noninvasive OWLiver® serum lipidomics test in a cohort of 117 patients with severe obesity undergoing bariatric surgery, comparing outcomes with liver biopsy. Exclusions (n = 24) included insufficient data, liver disease etiology other than MASLD, corticosteroid treatment, excessive alcohol consumption, low glomerular filtration rate, and declination to participate. Comprehensive laboratory tests, demographic assessments, and liver biopsies were performed. Serum metabolites were analyzed using OWLiver®, a serum lipidomic test that discriminates between healthy liver, steatosis, metabolic dysfunction-associated steatohepatitis (MASH), and MASH with fibrosis ≥2 by means of three algorithms run sequentially.

Results: Liver biopsy revealed a MASLD prevalence of 95.7%, with MASH present in 28.2% of cases. OWLiver® demonstrated a tendency to diagnose more severe cases. Body mass index (BMI), rather than the presence of type 2 diabetes, emerged as the sole independent factor linked to the probability of concordance. Therefore, the all-population concordance of 63.2% between OWLiver® and liver biopsy notably raised to 77.1% in patients with a BMI <40 kg/m2. These findings suggest a potential correlation between lower BMI and enhanced concordance between OWLiver® and biopsy.

Conclusion: This study yields valuable insights into the concordance between liver biopsy and the noninvasive serum lipidomic test, OWLiver®, in severe obesity. OWLiver® demonstrated a tendency to amplify MASLD severity, with BMI values influencing concordance. Patients with BMI <40 kg/m2 may derive optimal benefits from this noninvasive diagnostic approach.

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与代谢功能障碍相关的重度肥胖症脂肪肝以及侵入性（活检）和非侵入性（OWLiver®）诊断之间的一致性。

导言：非酒精性脂肪肝（NAFLD），现称为代谢功能障碍相关性脂肪性肝病（MASLD），是与肥胖和2型糖尿病相关的日益严重的健康问题。尽管肝脏活检是金标准，但其侵入性突出了对非侵入性诊断方法的需求：我们进行了一项横断面研究，使用无创的 OWLiver® 血清脂质组学测试对 117 名接受减肥手术的重度肥胖患者进行 MASLD 评估，并将结果与肝活检进行比较。排除项（n = 24）包括数据不足、MASLD 以外的肝病病因、皮质类固醇治疗、过度饮酒、肾小球滤过率低以及拒绝参与。研究人员进行了全面的实验室检查、人口统计学评估和肝活检。使用 OWLiver® 对血清代谢物进行了分析，这是一种血清脂质体检测方法，可通过三种算法依次区分健康肝脏、脂肪变性、代谢功能障碍相关性脂肪性肝炎（MASH）和纤维化≥2 的 MASH：肝活检显示，MASLD 的发病率为 95.7%，28.2% 的病例存在 MASH。OWLiver® 有诊断出更严重病例的趋势。体重指数（BMI），而非是否患有 2 型糖尿病，是唯一与一致性概率相关的独立因素。因此，在体重指数（BMI）为 40 kg/m² 的患者中，OWLiver® 和肝活检的全人群吻合率从 63.2% 显著提高到 77.1%。这些研究结果表明，体重指数越低，OWLiver® 和活组织检查的一致性就越高：这项研究对重度肥胖症患者的肝活检与非侵入性血清脂质组学检测 OWLiver® 的一致性提供了宝贵的见解。OWLiver®显示出放大MASLD严重程度的趋势，BMI值影响了两者的一致性。体重指数大于或等于 40 kg/m² 的患者可从这种无创诊断方法中获得最佳益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Facts 医学-内分泌学与代谢

CiteScore

6.80

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Obesity Facts'' publishes articles covering all aspects of obesity, in particular epidemiology, etiology and pathogenesis, treatment, and the prevention of adiposity. As obesity is related to many disease processes, the journal is also dedicated to all topics pertaining to comorbidity and covers psychological and sociocultural aspects as well as influences of nutrition and exercise on body weight. The editors carefully select papers to present only the most recent findings in clinical practice and research. All professionals concerned with obesity issues will find this journal a most valuable update to keep them abreast of the latest scientific developments.