The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosis

Background MASLD can manifest as hepatocellular damage, which can result in mild elevation of aminotransferases. However, in some patients, MASLD presents with cholestatic pattern. Objective To assess the impact of the biochemical pattern on the natural course of MASLD, including liver damage in his...

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Autores: Ampuero, J, Aller, R, Gallego-Durán, R, Crespo, J, Calleja, JL, García-Monzón, C, Gómez-Camarero, J, Caballería, J, Lo Iacono, O, Ibañez, L, García-Samaniego, J, Albillos, A, Francés, R, Fernández-Rodríguez, C, Maya-Miles, D, Diago, M, Poca, M, Andrade, RJ, Latorre, R, Jorquera, F, Morillas, RM, Escudero, D, Hernández-Guerra, M, Pareja-Megia, MJ, Banales, JM, Aspichueta, P, Benlloch, S, Rosales, JM, Turnes, J, Romero-Gómez, M
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p17020
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/17020
Access Level:acceso abierto
Palabra clave:Hepatocellular
Cholestasis
MASLD
Phenotypes
Transaminases
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spelling The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosisAmpuero, JAller, RGallego-Durán, RCrespo, JCalleja, JLGarcía-Monzón, CGómez-Camarero, JCaballería, JLo Iacono, OIbañez, LGarcía-Samaniego, JAlbillos, AFrancés, RFernández-Rodríguez, CMaya-Miles, DDiago, MPoca, MAndrade, RJLatorre, RJorquera, FMorillas, RMEscudero, DHernández-Guerra, MPareja-Megia, MJBanales, JMAspichueta, PBenlloch, SRosales, JMTurnes, JRomero-Gómez, MHepatocellularCholestasisMASLDPhenotypesTransaminasesBackground MASLD can manifest as hepatocellular damage, which can result in mild elevation of aminotransferases. However, in some patients, MASLD presents with cholestatic pattern. Objective To assess the impact of the biochemical pattern on the natural course of MASLD, including liver damage in histology, the accuracy of non-invasive tests(NITs), and prognosis. Methods Multicenter study enrolling 2156 patients with biopsy-proven MASLD, who were classified based on their[ALT/ULN)]/[(ALP/ULN)] levels at the time of biopsy: (a) hepatocellular pattern(H), > 5; (b) mixed pattern(M),2-5; (c) cholestatic pattern(C), < 2. Outcomes: (a) histological evaluation of the single components of NAS, MASH, and fibrosis; (b) NITs and transient elastography assessing advanced fibrosis; (c) prognosis determined by the appearance of decompensated cirrhosis and death. Results Out of the 2156 patients, 22.9% exhibited the H-pattern, whilst 31.7% exhibited the C-pattern. Severe steatosis, ballooning, lobular inflammation, and MASH (56.4% H vs. 41.9% M vs. 31.9% C) were more common in H-pattern (p = 0.0001),whilst C-pattern was linked to cirrhosis (5.8% H vs. 5.6% M vs. 10.9% C; p = 0.0001). FIB-4(0.74(95% CI 0.69-0.79) vs. 0.83 (95% CI 0.80-0.85); p = 0.005) and Hepamet Fibrosis Score(0.77 (95% CI 0.69-0.85) vs. 0.84 (95% CI 0.80-0.87); p = 0.044)exhibited lower AUROCs in the H-pattern. The C-pattern[HR 2.37 (95% CI 1.12-5.02); p = 0.024], along with age, diabetes, and cirrhosis were independently associated with mortality. Most patients maintained their initial biochemical pattern during the second evaluation. Conclusions The H-pattern exhibited greater necro-inflammation in the histology than the C-pattern, whereas the latter showed more cirrhosis. The accuracy of NITs in detecting fibrosis was decreased in H-pattern. The occurrence of decompensated events and mortality was predominant in C-pattern. Therefore, identifying MASLD phenotypes based on the biochemical presentation could be relevant for clinical practice.SPRINGER JAPAN KK2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/17020JOURNAL OF GASTROENTEROLOGYISSN: 09441174ISSNe: 14355922reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p170202026-06-11T12:45:17Z
dc.title.none.fl_str_mv The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosis
title The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosis
spellingShingle The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosis
Ampuero, J
Hepatocellular
Cholestasis
MASLD
Phenotypes
Transaminases
title_short The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosis
title_full The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosis
title_fullStr The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosis
title_full_unstemmed The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosis
title_sort The biochemical pattern defines MASLD phenotypes linked to distinct histology and prognosis
dc.creator.none.fl_str_mv Ampuero, J
Aller, R
Gallego-Durán, R
Crespo, J
Calleja, JL
García-Monzón, C
Gómez-Camarero, J
Caballería, J
Lo Iacono, O
Ibañez, L
García-Samaniego, J
Albillos, A
Francés, R
Fernández-Rodríguez, C
Maya-Miles, D
Diago, M
Poca, M
Andrade, RJ
Latorre, R
Jorquera, F
Morillas, RM
Escudero, D
Hernández-Guerra, M
Pareja-Megia, MJ
Banales, JM
Aspichueta, P
Benlloch, S
Rosales, JM
Turnes, J
Romero-Gómez, M
author Ampuero, J
author_facet Ampuero, J
Aller, R
Gallego-Durán, R
Crespo, J
Calleja, JL
García-Monzón, C
Gómez-Camarero, J
Caballería, J
Lo Iacono, O
Ibañez, L
García-Samaniego, J
Albillos, A
Francés, R
Fernández-Rodríguez, C
Maya-Miles, D
Diago, M
Poca, M
Andrade, RJ
Latorre, R
Jorquera, F
Morillas, RM
Escudero, D
Hernández-Guerra, M
Pareja-Megia, MJ
Banales, JM
Aspichueta, P
Benlloch, S
Rosales, JM
Turnes, J
Romero-Gómez, M
author_role author
author2 Aller, R
Gallego-Durán, R
Crespo, J
Calleja, JL
García-Monzón, C
Gómez-Camarero, J
Caballería, J
Lo Iacono, O
Ibañez, L
García-Samaniego, J
Albillos, A
Francés, R
Fernández-Rodríguez, C
Maya-Miles, D
Diago, M
Poca, M
Andrade, RJ
Latorre, R
Jorquera, F
Morillas, RM
Escudero, D
Hernández-Guerra, M
Pareja-Megia, MJ
Banales, JM
Aspichueta, P
Benlloch, S
Rosales, JM
Turnes, J
Romero-Gómez, M
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Hepatocellular
Cholestasis
MASLD
Phenotypes
Transaminases
topic Hepatocellular
Cholestasis
MASLD
Phenotypes
Transaminases
description Background MASLD can manifest as hepatocellular damage, which can result in mild elevation of aminotransferases. However, in some patients, MASLD presents with cholestatic pattern. Objective To assess the impact of the biochemical pattern on the natural course of MASLD, including liver damage in histology, the accuracy of non-invasive tests(NITs), and prognosis. Methods Multicenter study enrolling 2156 patients with biopsy-proven MASLD, who were classified based on their[ALT/ULN)]/[(ALP/ULN)] levels at the time of biopsy: (a) hepatocellular pattern(H), > 5; (b) mixed pattern(M),2-5; (c) cholestatic pattern(C), < 2. Outcomes: (a) histological evaluation of the single components of NAS, MASH, and fibrosis; (b) NITs and transient elastography assessing advanced fibrosis; (c) prognosis determined by the appearance of decompensated cirrhosis and death. Results Out of the 2156 patients, 22.9% exhibited the H-pattern, whilst 31.7% exhibited the C-pattern. Severe steatosis, ballooning, lobular inflammation, and MASH (56.4% H vs. 41.9% M vs. 31.9% C) were more common in H-pattern (p = 0.0001),whilst C-pattern was linked to cirrhosis (5.8% H vs. 5.6% M vs. 10.9% C; p = 0.0001). FIB-4(0.74(95% CI 0.69-0.79) vs. 0.83 (95% CI 0.80-0.85); p = 0.005) and Hepamet Fibrosis Score(0.77 (95% CI 0.69-0.85) vs. 0.84 (95% CI 0.80-0.87); p = 0.044)exhibited lower AUROCs in the H-pattern. The C-pattern[HR 2.37 (95% CI 1.12-5.02); p = 0.024], along with age, diabetes, and cirrhosis were independently associated with mortality. Most patients maintained their initial biochemical pattern during the second evaluation. Conclusions The H-pattern exhibited greater necro-inflammation in the histology than the C-pattern, whereas the latter showed more cirrhosis. The accuracy of NITs in detecting fibrosis was decreased in H-pattern. The occurrence of decompensated events and mortality was predominant in C-pattern. Therefore, identifying MASLD phenotypes based on the biochemical presentation could be relevant for clinical practice.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/17020
url https://fisabio.portalinvestigacion.com/publicaciones/17020
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SPRINGER JAPAN KK
publisher.none.fl_str_mv SPRINGER JAPAN KK
dc.source.none.fl_str_mv JOURNAL OF GASTROENTEROLOGY
ISSN: 09441174
ISSNe: 14355922
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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