Reduced Platelet Aggregation and Plasma Cytokine Levels Mitigate Progressive Metabolic Dysfunction-Associated...

Area of Science:

• Hepatology
• Cardiology
• Thrombosis

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is prevalent in patients with metabolic syndrome and coronary artery disease (CAD).
• MASLD is a leading cause of liver disease and contributes significantly to cardiovascular morbidity.
• Enhanced platelet aggregation is implicated in steatohepatitis, with antiplatelet therapy being a potential treatment strategy.

Purpose of the Study:

• To investigate the impact of antiplatelet therapy on hepatic fat, liver volume, and iron deposition in patients with MASLD.
• To explore the relationship between platelet function, systemic inflammation, and MASLD progression.
• To characterize thromboinflammatory mechanisms underlying MASLD.

Main Methods:

• A prospective study involving 51 patients with type 2 diabetes mellitus and/or obesity (BMI≥30).
• Magnetic resonance imaging (MRI) was used to assess hepatic fat, liver volume, and iron at baseline and six months.
• Ex vivo platelet function testing and plasma cytokine levels were measured.

Main Results:

• Increased platelet reactivity was associated with higher hepatic fat, iron deposition, and liver volume.
• Antiplatelet therapy correlated with reductions in liver volume and iron accumulation.
• MASLD progression was linked to dyslipidemia, platelet hyperreactivity, and elevated pro-inflammatory and pro-fibrotic chemokines.

Conclusions:

• Reduced platelet aggregation is linked to an attenuation of MASLD features.
• Antiplatelet therapy may decrease pro-inflammatory and pro-fibrotic signaling in MASLD.
• Assessing platelet reactivity and specific chemokines could advance MASLD understanding and treatment.