Predicting Fibrosis Stage in MASH: The Role of Total Metabolic Syndrome Score and MMP-1
<i>Background and Objectives</i>: Fibrosis stage is the key histopathological determinant of liver-related outcomes in metabolic dysfunction-associated steatohepatitis (MASH); however, a reliable noninvasive method for predicting fibrosis stage remains an unmet need. This study aimed to...
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MDPI AG
2025-06-01
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| author | Bahadır Köylü Cenk Sökmensüer Muşturay Karçaaltıncaba Onur Keskin |
| author_facet | Bahadır Köylü Cenk Sökmensüer Muşturay Karçaaltıncaba Onur Keskin |
| author_sort | Bahadır Köylü |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Fibrosis stage is the key histopathological determinant of liver-related outcomes in metabolic dysfunction-associated steatohepatitis (MASH); however, a reliable noninvasive method for predicting fibrosis stage remains an unmet need. This study aimed to develop an accurate, practical, and noninvasive tool for identifying “at-risk MASH patients”. <i>Materials and Methods</i>: Fifty-six patients with biopsy-confirmed MASH were prospectively enrolled and categorized into fibrosis stages using the NASH-CRN system. In addition to anthropometric and biochemical parameters, seven serum fibrosis biomarkers were evaluated across fibrosis stages. Binary logistic regression analysis was used to construct a scoring model for predicting ≥F2 fibrosis. The diagnostic performance of the proposed model was compared with established noninvasive tests (NITs) and magnetic resonance elastography (MRE) for detecting both ≥F2 and ≥F3 fibrosis. <i>Results</i>: The total metabolic syndrome score was the only variable that significantly distinguished between F1 and F2 stages (<i>p</i> = 0.039). Among the biomarkers, matrix metalloproteinase-1 (MMP-1) showed a significant difference across fibrosis groups (<i>p</i> = 0.009). The AST/ALT ratio was the most robust predictor for differentiating ≥F3 (<i>p</i> < 0.001). A scoring model integrating the total metabolic syndrome score, MMP-1, and AST/ALT ratio demonstrated superior diagnostic accuracy for identifying ≥F2 (AUROC 0.88, 95% CI 0.79–0.97) compared to other NITs and MRE, and strong performance for detecting ≥F3 (AUROC 0.95, 95% CI 0.90–1.00). <i>Conclusions</i>: Total metabolic syndrome score and MMP-1 are promising candidates for future approaches. Combining total metabolic syndrome score, MMP-1, and AST/ALT ratio might detect ≥F2 in MASH with higher diagnostic accuracy than other NITs and MRE. |
| format | Article |
| id | doaj-art-e52e1ba11fbb4f2a8d089aa4c13a42c0 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-e52e1ba11fbb4f2a8d089aa4c13a42c02025-08-20T03:27:21ZengMDPI AGMedicina1010-660X1648-91442025-06-01616110210.3390/medicina61061102Predicting Fibrosis Stage in MASH: The Role of Total Metabolic Syndrome Score and MMP-1Bahadır Köylü0Cenk Sökmensüer1Muşturay Karçaaltıncaba2Onur Keskin3Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06230 Ankara, TurkeyDepartment of Pathology, Faculty of Medicine, Hacettepe University, 06230 Ankara, TurkeyDepartment of Radiology, Faculty of Medicine, Hacettepe University, 06230 Ankara, TurkeyDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey<i>Background and Objectives</i>: Fibrosis stage is the key histopathological determinant of liver-related outcomes in metabolic dysfunction-associated steatohepatitis (MASH); however, a reliable noninvasive method for predicting fibrosis stage remains an unmet need. This study aimed to develop an accurate, practical, and noninvasive tool for identifying “at-risk MASH patients”. <i>Materials and Methods</i>: Fifty-six patients with biopsy-confirmed MASH were prospectively enrolled and categorized into fibrosis stages using the NASH-CRN system. In addition to anthropometric and biochemical parameters, seven serum fibrosis biomarkers were evaluated across fibrosis stages. Binary logistic regression analysis was used to construct a scoring model for predicting ≥F2 fibrosis. The diagnostic performance of the proposed model was compared with established noninvasive tests (NITs) and magnetic resonance elastography (MRE) for detecting both ≥F2 and ≥F3 fibrosis. <i>Results</i>: The total metabolic syndrome score was the only variable that significantly distinguished between F1 and F2 stages (<i>p</i> = 0.039). Among the biomarkers, matrix metalloproteinase-1 (MMP-1) showed a significant difference across fibrosis groups (<i>p</i> = 0.009). The AST/ALT ratio was the most robust predictor for differentiating ≥F3 (<i>p</i> < 0.001). A scoring model integrating the total metabolic syndrome score, MMP-1, and AST/ALT ratio demonstrated superior diagnostic accuracy for identifying ≥F2 (AUROC 0.88, 95% CI 0.79–0.97) compared to other NITs and MRE, and strong performance for detecting ≥F3 (AUROC 0.95, 95% CI 0.90–1.00). <i>Conclusions</i>: Total metabolic syndrome score and MMP-1 are promising candidates for future approaches. Combining total metabolic syndrome score, MMP-1, and AST/ALT ratio might detect ≥F2 in MASH with higher diagnostic accuracy than other NITs and MRE.https://www.mdpi.com/1648-9144/61/6/1102fatty liverbiomarkermagnetic resonance elastographyliver fibrosis |
| spellingShingle | Bahadır Köylü Cenk Sökmensüer Muşturay Karçaaltıncaba Onur Keskin Predicting Fibrosis Stage in MASH: The Role of Total Metabolic Syndrome Score and MMP-1 Medicina fatty liver biomarker magnetic resonance elastography liver fibrosis |
| title | Predicting Fibrosis Stage in MASH: The Role of Total Metabolic Syndrome Score and MMP-1 |
| title_full | Predicting Fibrosis Stage in MASH: The Role of Total Metabolic Syndrome Score and MMP-1 |
| title_fullStr | Predicting Fibrosis Stage in MASH: The Role of Total Metabolic Syndrome Score and MMP-1 |
| title_full_unstemmed | Predicting Fibrosis Stage in MASH: The Role of Total Metabolic Syndrome Score and MMP-1 |
| title_short | Predicting Fibrosis Stage in MASH: The Role of Total Metabolic Syndrome Score and MMP-1 |
| title_sort | predicting fibrosis stage in mash the role of total metabolic syndrome score and mmp 1 |
| topic | fatty liver biomarker magnetic resonance elastography liver fibrosis |
| url | https://www.mdpi.com/1648-9144/61/6/1102 |
| work_keys_str_mv | AT bahadırkoylu predictingfibrosisstageinmashtheroleoftotalmetabolicsyndromescoreandmmp1 AT cenksokmensuer predictingfibrosisstageinmashtheroleoftotalmetabolicsyndromescoreandmmp1 AT musturaykarcaaltıncaba predictingfibrosisstageinmashtheroleoftotalmetabolicsyndromescoreandmmp1 AT onurkeskin predictingfibrosisstageinmashtheroleoftotalmetabolicsyndromescoreandmmp1 |