Blood-based MASH diagnostic in candidates for bariatric surgery using mid-infrared spectroscopy: a European...

Area of Science:

• Hepatology
• Metabolic Disorders
• Medical Diagnostics

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is prevalent in obese individuals, with significant sexual dimorphism observed.
• A critical unmet need exists for noninvasive diagnostic tools to assess MASLD severity, particularly for identifying Metabolic dysfunction-associated steatohepatitis (MASH).

Purpose of the Study:

• To evaluate the efficacy of a novel blood test utilizing mid-infrared (MIR) metabolic fingerprinting for diagnosing MASH in patients with severe or morbid obesity.
• To establish a diagnostic algorithm and threshold for MASH detection using MIR spectroscopy.

Main Methods:

• A prospective, European multicenter study enrolled 382 individuals with severe/morbid obesity undergoing bariatric surgery.
• Liver biopsies were centrally assessed to confirm MASH presence.
• A diagnostic algorithm was developed from MIR spectra to classify MASH status.

Main Results:

• In women (n=217), MASH was diagnosed in 14.3%. The MIR test achieved high diagnostic performance (AUC 0.83/0.82) and could rule out MASH with 94-97% NPV.
• In men (n=78), MASH prevalence was 33.3%, but the MIR spectral model showed poor diagnostic performance.
• The developed algorithm demonstrated good sensitivity (70-86%) and specificity (75-81%) in women.

Conclusions:

• Mid-infrared metabolic fingerprinting shows potential as a noninvasive tool to rule out MASH in women with severe or morbid obesity.
• The diagnostic utility of this MIR-based blood test in men requires further investigation in dedicated studies.