Abstract：
Significance of autoantibodies in pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) is unknown. Our aim was to determine the prevalence and significance of autoantibodies in MASLD. PubMed and Scopus were searched and six articles (689 [487 males] MASLD patients) were identified. Antinuclear antibodies (ANA) was positive in 28% (95% confidence interval [CI]: 17%-39%, n = 6 studies), Antismooth muscle antibodies (ASMA) in 28% (95% CI: 8%-50%, n = 5 studies), Actin-positive in 15% (95% CI: 10%-20%, n = 2 studies) and elevated immunoglobulin G in 17% (95% CI: 1%-39%, n = 4 studies). Anti-liver-kidney-microsomal antibody was not present in any patient. There was no significant association of ANA positivity with degree of liver steatosis, liver fibrosis or nonalcoholic fatty liver disease activity score (NAS) but patients with ASMA positivity had advanced fibrosis (pooled risk ratio [RR] 1.77; 95% CI 1.16-2.71) and higher risk of NAS ≥5 (pooled RR 1.21; 95% CI: 1.01-1.44, n = 2 studies, 243 patients). To conclude, non-organ specific autoantibodies are present in over one-fourth of children with MASLD and the presence of ASMA maybe associated with increased disease severity.
摘要：
自身抗体在小儿代谢功能障碍相关脂肪变性肝病（MASLD）中的意义尚不清楚。我们的目的是确定MASLD中自身抗体的患病率和意义。检索了PubMed和Scopus，并确定了六篇文章（689[487男性]MASLD患者）。抗核抗体（ANA）在28％（95％置信区间[CI]：17％-39％，n=6项研究)，抗肌肉抗体（ASMA）占28％（95％CI：8％-50％，n=5项研究)，15%的肌动蛋白阳性（95%CI：10%-20%，n=2项研究）和17％的免疫球蛋白G升高（95％CI：1％-39％，n=4项研究)。任何患者均不存在抗肝肾微粒体抗体。ANA阳性与肝脏脂肪变性程度无显著关联，肝纤维化或非酒精性脂肪性肝病活动评分（NAS），但ASMA阳性的患者具有晚期纤维化（合并风险比[RR]1.77;95％CI1.16-2.71）和NAS≥5的风险较高（合并RR1.21;95％CI：1.01-1.44，n=2项研究，243名患者)。最后，超过1/4的MASLD患儿存在非器官特异性自身抗体,ASMA的存在可能与疾病严重程度增加相关.
