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Comparative Analysis of Metabolic and Inflammatory Biomarker Profiles in Phenotypes of Metabolic
Sumbal Nida1, Dilshad Ahmed Khan1, Muhammad Qaiser Alam Khan1
1Department of Chemical Pathology, Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, Pakistan.
Objective:
To investigate the differences in metabolic and inflammatory biomarker profiles across three metabolic dysfunction-associated fatty liver disease (MAFLD) phenotypes.
Study Design:
A comparative observational study. Place and Duration of the Study: This study was conducted at Pakistan Aeronautical Complex Hospital Kamra, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from November 2021 to March 2024.
Methodology:
This study included 393 patients (aged 20-70 years) with ultrasound-confirmed hepatic steatosis and a fatty liver index (FLI) ≥30. Patients were categorised into T2D-associated MAFLD (n = 134), obesity-MAFLD (n = 221), and lean-MAFLD (n = 38) groups according to the MAFLD diagnostic criteria. Healthy controls (n = 109) were included for comparison. Anthropometric parameters (body mass index [BMI], waist circumference [WC]), biochemical markers (liver enzymes, lipid profile), inflammatory cytokines (high-sensitivity C-reactive protein, interleukin-6, tumour necrosis factor-alpha, adiponectin, leptin, cytokeratin-18, malondialdehyde), and markers of hepatic fibrosis were measured.
Results:
MAFLD patients had higher BMI, WC, metabolic, and inflammatory biomarkers compared to healthy controls (p <0.001). T2D- MAFLD patients had elevated lipid profiles, liver enzymes, inflammatory cytokines, and fibrosis indices as compared to other two groups (p <0.001). The Obese-MAFLD group showed elevated triglycerides, FLI, cytokines, and leptin (p <0.001) compared to the lean-MAFLD group. Lean-MAFLD patients exhibited higher fasting glucose and blood pressure than the obese phenotype (p <0.05).
Conclusion:
The MAFLD phenotypes exhibit distinct biomarker profiles. The T2D-MAFLD group had the most severe metabolic and inflammatory dysfunction, while the obese-MAFLD group showed moderate liver and lipid abnormalities. The lean-MAFLD group had mild metabolic disturbances. Identifying phenotype-specific biomarkers may aid early detection, risk assessment, and personalised treatment to improve patient outcomes.
Key Words:
Metabolic dysfunction-associated fatty liver disease, T2D MAFLD, Obese -MAFLD, Lean-MAFLD, Biochemical and inflammatory markers.
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