Perfiles inflamatorios específicos del fenotipo en la enfermedad del hígado graso: implicaciones para la...

Área de la Ciencia:

• Hepatology
• Immunology
• Internal Medicine

Sus antecedentes:

• Liver fibrosis is a critical prognostic factor in steatotic liver diseases (SLD), encompassing metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic and alcohol-associated liver disease (MetALD), and alcohol-related liver disease (ALD).
• Understanding the distinct inflammatory profiles and their relationship with fibrosis across these SLD phenotypes is crucial for accurate prognostication and management.

Objetivo del estudio:

• To compare systemic inflammation and fibrosis severity across MASLD, MetALD, and ALD phenotypes.
• To investigate the correlation between inflammatory markers and the presence of fibrosis.
• To evaluate the association between immune-inflammatory markers and the severity of liver fibrosis.

Principales métodos:

• 180 patients with SLD were categorized into MASLD (n=69), MetALD (n=43), and ALD (n=68) groups.
• Transient elastography assessed liver stiffness for advanced fibrosis (≥12 kPa).
• Systemic immune-inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), and fibrosis scores (FIB-4, APRI, Agile 3+ MELD, CTP) were analyzed using correlation and regression.

Principales resultados:

• Alcohol-related liver disease (ALD) patients exhibited the highest neutrophilic burden (mean NLR 6.56), while MASLD patients showed a lymphocyte-predominant profile (mean LMR 4.86).
• Advanced fibrosis was prevalent in 149 patients, with the highest burden in ALD (mean liver stiffness 27.43 kPa), similar in MetALD and MASLD.
• A composite score derived from inflammatory markers accurately identified patients with advanced fibrosis.

Conclusiones:

• MASLD, MetALD, and ALD present unique inflammatory signatures despite overlapping clinical features.
• Systemic immune-inflammatory markers, particularly NLR, are significantly associated with liver fibrosis severity.
• The developed Fibrosis-Inflammation Risk Model Score offers a potential scalable and cost-effective tool for identifying advanced fibrosis, pending further validation.