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 h...

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Autores: Ampuero, Javier, Aller, Rocío, Crespo García, Javier, Calleja, José Luis, García-Monzón, Carmelo, Gómez-Camarero, Judith, Caballería, Joan, Lo Iacono, Oreste, Ibáñez, Luis, García-Samaniego, Javier, Albillos, Agustín, Francés, Rubén, Fernández-Rodríguez, Conrado, Maya-Miles, Douglas, Diago, Moisés, Poca, María, Andrade, Raúl J., Latorre, Raquel, Jorquera, Francisco, Morillas, Rosa María
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universidad de Cantabria (UC)
Repositorio:UCrea Repositorio Abierto de la Universidad de Cantabria
Idioma:inglés
OAI Identifier:oai:repositorio.unican.es:10902/33032
Acceso en línea:https://hdl.handle.net/10902/33032
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, JavierAller, RocíoCrespo García, JavierCalleja, José LuisGarcía-Monzón, CarmeloGómez-Camarero, JudithCaballería, JoanLo Iacono, OresteIbáñez, LuisGarcía-Samaniego, JavierAlbillos, AgustínFrancés, RubénFernández-Rodríguez, ConradoMaya-Miles, DouglasDiago, MoisésPoca, MaríaAndrade, Raúl J.Latorre, RaquelJorquera, FranciscoMorillas, Rosa MaríaHepatocellularCholestasisMASLDPhenotypesTransaminasesBackground: 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.Funding: Funding for open access publishing: Universidad de Sevilla/ CBUA. JA is funded by the “Spanish Ministry of Economy, Innovation and Competition, Instituto de Salud Carlos III” (PI19/01404, PI22/01345, and GLD19/00100). JMB is funded by Spanish Carlos III Health Institute (ISCIII) (FIS PI18/01075, PI21/00922 and Miguel Servet Program CPII19/00008) cofnanced by “Fondo Europeo de Desarrollo Regional” (FEDER), Department of Health of the Basque Country (2017111010, 2020111077), “Euskadi RIS3” (2022333032), La Caixa Scientifc Foundation (HR17-00601), European Union’s Horizon 2020 Research and Innovation Program (grant number 825510, ESCALON). PA is funded by Gobierno Vasco IT1476-22; MCIU/AEI/ FEDER, UE (PDI2021-124425OB-I00). *The funders have not had any role in the design, analysis, writing, or interpretation of this project.Springer NatureUniversidad de Cantabria20242024-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttps://hdl.handle.net/10902/33032Journal of Gastroenterology, 2024reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/330322026-06-02T12:39:31Z
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, Javier
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, Javier
Aller, Rocío
Crespo García, Javier
Calleja, José Luis
García-Monzón, Carmelo
Gómez-Camarero, Judith
Caballería, Joan
Lo Iacono, Oreste
Ibáñez, Luis
García-Samaniego, Javier
Albillos, Agustín
Francés, Rubén
Fernández-Rodríguez, Conrado
Maya-Miles, Douglas
Diago, Moisés
Poca, María
Andrade, Raúl J.
Latorre, Raquel
Jorquera, Francisco
Morillas, Rosa María
author Ampuero, Javier
author_facet Ampuero, Javier
Aller, Rocío
Crespo García, Javier
Calleja, José Luis
García-Monzón, Carmelo
Gómez-Camarero, Judith
Caballería, Joan
Lo Iacono, Oreste
Ibáñez, Luis
García-Samaniego, Javier
Albillos, Agustín
Francés, Rubén
Fernández-Rodríguez, Conrado
Maya-Miles, Douglas
Diago, Moisés
Poca, María
Andrade, Raúl J.
Latorre, Raquel
Jorquera, Francisco
Morillas, Rosa María
author_role author
author2 Aller, Rocío
Crespo García, Javier
Calleja, José Luis
García-Monzón, Carmelo
Gómez-Camarero, Judith
Caballería, Joan
Lo Iacono, Oreste
Ibáñez, Luis
García-Samaniego, Javier
Albillos, Agustín
Francés, Rubén
Fernández-Rodríguez, Conrado
Maya-Miles, Douglas
Diago, Moisés
Poca, María
Andrade, Raúl J.
Latorre, Raquel
Jorquera, Francisco
Morillas, Rosa María
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
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
2024-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10902/33032
url https://hdl.handle.net/10902/33032
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Springer Nature
publisher.none.fl_str_mv Springer Nature
dc.source.none.fl_str_mv Journal of Gastroenterology, 2024
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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