Serum‐free light chains as a dependable biomarker for stratifying patients with metabolic dysfunction‐associated steatotic liver disease

Author:

Liguori Antonio1234,D'Ambrosio Francesca5ORCID,Napodano Cecilia5ORCID,Gentili Vanessa5,Giustiniani Maria Cristina6,Pompili Maurizio12,Grieco Antonio12ORCID,Rapaccini Gianludovico12,Urbani Andrea5,Gasbarrini Antonio123ORCID,Basile Umberto7,Miele Luca1234ORCID,

Affiliation:

1. Department of Medical and Surgical Sciences Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy

2. Department of Translational Medicine and Surgery Università Cattolica del Sacro Cuore Rome Italy

3. Internal Medicine and Liver Transplant Unit Fondazione Policlinico Universitario A, Gemelli IRCCS Rome Italy

4. CEMAD, Digestive Disease Center Fondazione Policlinico Universitario A, Gemelli IRCCS Rome Italy

5. Department of Laboratory and Infectious Diseases Sciences Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy

6. Department of Women, Children and Public Health Sciences Fondazione Policlinico Universitario A, Gemelli IRCCS Rome Italy

7. Department of Clinical Pathology Santa Maria Goretti HospitalAUSL Latina Latina Italy

Abstract

AbstractBackground and AimsAdaptive 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.MethodsWe 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.ResultsWe 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.ConclusionsFLCs could be a simple biomarker for stratification of cACLD in MASLD patients.

Publisher

Wiley

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