Abstract：
OBJECTIVE: Adaptive immunity is gaining a significant role in progression of metabolic dysfunction-associated steatotic liver disease (MASLD). B-cell activity can be assessed by serum-free light chains (sFLCs) k and λ levels. The objective of the present investigation is to examine the utility of sFLCs as non-invasive biomarkers for the stratification of MASLD.
METHODS: We enrolled a consecutive cohort from an outpatient liver unit. Diagnosis of metabolic dysfunction-associated steatohepatitis (MASH) was made with liver biopsy according to current guidelines. Compensated advanced chronic liver disease (cACLD) and clinically significant portal hypertension (CSPH) were defined according to Baveno VII criteria. sFLCs were measured by turbidimetry using an immunoassay.
RESULTS: We evaluated 254 patients, 162/254 (63.8%) were male. Median age was 54 years old, and the median body mass index was 28.4 kg/m2. A total of 157/254 (61.8%) subjects underwent liver biopsy: 88 had histological diagnosis of MASH, 89 were considered as simple metabolic dysfunction-associated steatotic liver (MASL) and 77/254 (30.3%) patients with compensated metabolic dysfunction-associated cirrhosis. By using Baveno VII criteria, 101/254 (39.7%) patients had cACLD; among them, 45/101 (44.5%) had CSPH. Patients with cACLD showed higher sFLC levels compared with patients without cACLD (p < .01), and patients with CSPH showed higher sFLC levels than patients without CSPH (p < .01). At multivariable analysis, sFLCs were associated with cACLD (p < .05) independently from γ-globulins and other known dysmetabolic risk factors. κFLC was associated with CSPH (p < .05) independently from γ-globulins and other known dysmetabolic risk factors.
CONCLUSIONS: sFLCs could be a simple biomarker for stratification of cACLD in MASLD patients.
METHODS: We enrolled a consecutive cohort from an outpatient liver unit. Diagnosis of metabolic dysfunction-associated steatohepatitis (MASH) was made with liver biopsy according to current guidelines. Compensated advanced chronic liver disease (cACLD) and clinically significant portal hypertension (CSPH) were defined according to Baveno VII criteria. sFLCs were measured by turbidimetry using an immunoassay.
RESULTS: We evaluated 254 patients, 162/254 (63.8%) were male. Median age was 54 years old, and the median body mass index was 28.4 kg/m2. A total of 157/254 (61.8%) subjects underwent liver biopsy: 88 had histological diagnosis of MASH, 89 were considered as simple metabolic dysfunction-associated steatotic liver (MASL) and 77/254 (30.3%) patients with compensated metabolic dysfunction-associated cirrhosis. By using Baveno VII criteria, 101/254 (39.7%) patients had cACLD; among them, 45/101 (44.5%) had CSPH. Patients with cACLD showed higher sFLC levels compared with patients without cACLD (p < .01), and patients with CSPH showed higher sFLC levels than patients without CSPH (p < .01). At multivariable analysis, sFLCs were associated with cACLD (p < .05) independently from γ-globulins and other known dysmetabolic risk factors. κFLC was associated with CSPH (p < .05) independently from γ-globulins and other known dysmetabolic risk factors.
CONCLUSIONS: sFLCs could be a simple biomarker for stratification of cACLD in MASLD patients.
摘要：
目的：适应性免疫在代谢功能障碍相关的脂肪变性肝病（MASLD）的进展中发挥着重要作用。B细胞活性可以通过无血清轻链(sFLC)k和λ水平来评估。本研究的目的是检查sFLC作为MASLD分层的非侵入性生物标志物的实用性。
方法：我们从门诊肝脏单元连续招募了一个队列。根据目前的指南，通过肝活检对代谢功能障碍相关脂肪性肝炎（MASH）进行诊断。根据BavenoVII标准定义代偿性晚期慢性肝病（cACLD）和临床上显着的门静脉高压（CSPH）。sFLC通过使用免疫测定的比浊法测量。
结果：我们评估了254例患者，162/254（63.8%）为男性。中位年龄是54岁，中位体重指数为28.4kg/m2。共有157/254（61.8%）受试者接受了肝活检：88例具有MASH的组织学诊断，89被认为是简单的代谢功能障碍相关的脂肪变性肝（MASL）和77/254（30.3％）患者代偿代谢功能障碍相关的肝硬化。通过使用BavenoVII标准，101/254(39.7%)患者有cACLD；其中，45/101（44.5%）有CSPH。与没有cACLD的患者相比，有cACLD的患者显示更高的sFLC水平（p<0.01），CSPH患者的sFLC水平高于无CSPH患者（p<0.01）。在多变量分析中，sFLC与cACLD（p<.05）相关，独立于γ-球蛋白和其他已知的代谢异常危险因素。κFLC与CSPH（p<.05）相关，独立于γ-球蛋白和其他已知的代谢异常危险因素。
结论：sFLC可能是MASLD患者cACLD分层的简单生物标志物。
方法：我们从门诊肝脏单元连续招募了一个队列。根据目前的指南，通过肝活检对代谢功能障碍相关脂肪性肝炎（MASH）进行诊断。根据BavenoVII标准定义代偿性晚期慢性肝病（cACLD）和临床上显着的门静脉高压（CSPH）。sFLC通过使用免疫测定的比浊法测量。
结果：我们评估了254例患者，162/254（63.8%）为男性。中位年龄是54岁，中位体重指数为28.4kg/m2。共有157/254（61.8%）受试者接受了肝活检：88例具有MASH的组织学诊断，89被认为是简单的代谢功能障碍相关的脂肪变性肝（MASL）和77/254（30.3％）患者代偿代谢功能障碍相关的肝硬化。通过使用BavenoVII标准，101/254(39.7%)患者有cACLD；其中，45/101（44.5%）有CSPH。与没有cACLD的患者相比，有cACLD的患者显示更高的sFLC水平（p<0.01），CSPH患者的sFLC水平高于无CSPH患者（p<0.01）。在多变量分析中，sFLC与cACLD（p<.05）相关，独立于γ-球蛋白和其他已知的代谢异常危险因素。κFLC与CSPH（p<.05）相关，独立于γ-球蛋白和其他已知的代谢异常危险因素。
结论：sFLC可能是MASLD患者cACLD分层的简单生物标志物。
