Search Results (664)

Obstructive sleep apnea (OSA), characterized by intermittent hypoxia (IH), is strongly associated with metabolic syndrome and metabolic dysfunction-associated steatotic liver disease (MASLD). IH exacerbates MASLD progression through oxidative stress, inflammation, and lipid accumulation. This study aims to investigate the impact of oxygen normalization on metabolic dysfunction in OSA patients using continuous positive airway pressure (CPAP) therapy, and in mice exposed to IH followed by a reoxygenation period. In the clinical study, 76 participants (44 OSA patients and 32 controls) were analyzed. OSA patients had higher insulin resistance, triglycerides, very low density lipoprotein (VLDL) content, and liver enzyme levels, along with a higher prevalence of liver steatosis. After 18 months of CPAP therapy, OSA patients showed significant improvements in insulin resistance, lipid profiles (total cholesterol and VLDL), liver function markers (AST and albumin), and steatosis risk scores (Fatty Liver Index and OWLiver test). In the experimental study, IH induced hepatic lipid accumulation, oxidative stress, and inflammation, and reoxygenation reversed these deleterious effects in mice. At the molecular level, IH downregulated fatty acid oxidation (FAO)-related genes, thus impairing the FAO process. Reoxygenation maintained elevated levels of lipogenic genes but restored FAO gene expression and activity, suggesting enhanced lipid clearance despite ongoing lipogenesis. Indeed, serum β hydroxybutyrate, a key marker of hepatic FAO in patients, was impaired in OSA patients but normalized after CPAP therapy, supporting improved FAO function. CPAP therapy improves lipid profiles, liver function, and MASLD progression in OSA patients. Experimental findings highlight the therapeutic potential of oxygen normalization in reversing IH-induced liver damage by FAO pathway restoration, indicating a metabolic reprogramming in the liver. Full article

Objectives: Paratubal cysts (PTCs) are embryological remnants and are potentially hormonally responsive. Since hyperandrogenism (HA) is representative of polycystic ovary syndrome (PCOS), we examined whether biochemical hyperandrogenism is associated with PTCs in women with PCOS and if body mass index (BMI) and insulin resistance (IR) mediate this association. Methods: This retrospective study included 577 women diagnosed with PCOS at a tertiary academic center from 2010 to 2018. Clinical data included age at diagnosis, BMI, and diagnoses of hypertension, non-alcoholic fatty liver disease, and metabolic syndrome. Laboratory measures included total testosterone, sex hormone-binding globulin, anti-Müllerian hormone, luteinizing hormone, fasting glucose, insulin, and triglycerides (TG). Derived indices included a free androgen index (FAI), homeostasis model assessment of insulin resistance (HOMA-IR), and fasting glucose-to-insulin ratio. PTCs were identified through imaging or surgical findings. Structural equation modeling (SEM) assessed direct and indirect relationships between FAI, BMI, HOMA-IR, and PTCs, while adjusting for diagnostic age. Results: PTCs were identified in 2.77% of participants. BMI, FAI, TG, and IR indices were significantly higher for women with PTCs than those without PTCs. SEM revealed significant indirect effects of FAI on PTCs via BMI and HOMA-IR. The direct effect was negative, resulting in a non-significant total effect. A sensitivity model using HOMA-IR as the predictor showed a significant direct effect on PTCs without mediation via FAI. Conclusions: Biochemical HA may influence PTC development in PCOS through metabolic pathways, establishing the need to consider metabolic context when evaluating adnexal cysts in hyperandrogenic women. Full article

Background: Restrictive lung disease (RLD) is a potential complication in type 2 diabetes (T2D), but its relationship with insulin resistance and liver-related metabolic dysfunction remains unclear. This study evaluated the association between lung function and metabolic markers in T2D and retrospectively assessed whether metabolic improvements from dietary intervention were accompanied by changes in lung function. Methods: This cross-sectional analysis included 184 individuals (101 with T2D, 33 with prediabetes, and 50 glucose-tolerant individuals). Lung function parameters—vital capacity (VC), total lung capacity by plethysmography (TLC-B), and diffusion capacity for carbon monoxide (TL_CO)—were assessed alongside metabolic markers including HOMA2-IR, fatty liver index (FLI), NAFLD score, and Fibrosis-4 index (FIB-4). In a subset of 54 T2D participants, lung function was reassessed after six months following either a fasting-mimicking diet (FMD, n = 14), Mediterranean diet (n = 13), or no dietary intervention (n = 27). Results: T2D participants had significantly lower VC and TLC-B compared to glucose-tolerant and prediabetic individuals, with 18–21% falling below clinical thresholds for RLD. Lung volumes were negatively correlated with HOMA2-IR, FLI, NAFLD score, and FIB-4 across the cohort and within the T2D group. Although the FMD intervention led to significant improvements in HOMA2-IR and FLI, no corresponding changes in lung function were observed over the six-month period. Conclusions: Restrictive lung impairment in T2D is associated with insulin resistance and markers of liver steatosis and fibrosis. While short-term dietary interventions can improve metabolic parameters, their effect on lung function may require a longer duration or additional interventions and targeted follow-up. These findings highlight the relevance of pulmonary assessment in individuals with metabolic dysfunction. Full article

Background: Environmental exposures, such as per- and polyfluoroalkyl substances (PFAS), in conjunction with social and behavioral factors, can significantly impact liver health. This research investigates the combined effects of PFAS (perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), alcohol consumption, smoking, income, and education on liver function among the U.S. population, utilizing data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). Methods: PFAS concentrations in blood samples were analyzed using online solid-phase extraction combined with liquid chromatography–tandem mass spectrometry (LC-MS/MS), a highly sensitive and specific method for detecting levels of PFAS. Liver function was evaluated using biomarkers such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), total bilirubin, and the fatty liver index (FLI). Descriptive statistics and multivariable linear regression analyses were employed to assess the associations between exposures and liver outcomes. Bayesian Kernel Machine Regression (BKMR) was utilized to explore the nonlinear and interactive effects of these exposures. To determine the relative influence of each factor on liver health, Posterior Inclusion Probabilities (PIPs) were calculated. Results: Linear regression analyses indicated that income and education were inversely associated with several liver injury biomarkers, while alcohol use and smoking demonstrated stronger and more consistent associations. Bayesian Kernel Machine Regression (BKMR) further highlighted alcohol and smoking as the most influential predictors, particularly for GGT and total bilirubin, with posterior inclusion probabilities (PIPs) close to 1.0. In contrast, PFAS showed weaker associations. Regression coefficients were small and largely non-significant, and PIPs were comparatively lower across most liver outcomes. Notably, education had a higher PIP for ALT and GGT than PFAS, suggesting a more protective role in liver health. People with higher education levels tend to live healthier lifestyles, have better access to healthcare, and are generally more aware of health risks. These factors can all help reduce the risk of liver problems. Overall mixture effects demonstrated nonlinear trends, including U-shaped relationships for ALT and GGT, and inverse associations for AST, FLI, and ALP. Conclusion: These findings underscore the importance of considering both environmental and social–behavioral determinants in liver health. While PFAS exposures remain a long-term concern, modifiable lifestyle and structural factors, particularly alcohol, smoking, income, and education, exert more immediate and pronounced effects on hepatic biomarkers in the general population. Full article

The objective of this experiment was to investigate the effects of tartary buckwheat flavonoids (TBF) and 25-hydroxyvitamin D₃ (25-OHD) on fatty liver syndrome (FLS) in laying hens. A total of 450 35-wk-old Lohmann laying hens were selected and randomly divided into five groups, with six replicates per treatment and 15 laying hens in each replicate. The control group was fed a corn-soybean meal basal diet. The FLS group was fed a high- energy–low-protein (HELP) diet, and the other three experimental groups were fed HELP diets supplemented with 60 mg/kg TBF, 69 μg/kg 25-OHD, and 60 mg/kg TBF plus 69 μg/kg 25-OHD, respectively. The experiment lasted 8 weeks. The results demonstrated that feeding laying hens with a HELP diet led to a significant accumulation of fat in their livers, liver enlargement and yellowing, as well as a decline in liver antioxidant capacity and an aggravation of inflammation. TBF alone, 25-OHD alone, and their combination had no effect on the laying performance of laying hens fed with a HELP diet. However, 25-OHD significantly enhanced the albumin content, eggshell strength, and eggshell thickness of eggs (p < 0.05). Compared with the HELP group, TBF, 25-OHD, or their combination reduced serum LDL-C and TG (p < 0.05). The combined treatment further lowered serum NEFA and MDA, enhanced liver SOD activity (p < 0.05), and unlike TBF alone (which reduced hepatic TG) or 25-OHD alone (which decreased liver index), reduced both liver index and hepatic TG (p < 0.05). Liver gene expression analysis showed that combined TBF and 25-OHD significantly inhibited the expression of fat synthesis-related genes (ACC, FAS, GPAT1, ChREBP1, LXRα, SREBP-1C, SREBP-2, FABP) as well as inflammation-related genes (IL-6, TNF-α, NF-κB, TLR4) (p < 0.05). At the phylum level of the cecal microbiota, TBF increased the abundance of Bacteroidota (p < 0.05), and combined TBF and 25-OHD tended to increase the abundance of Firmicutes_D. At the genus level, TBF increased the abundance of Phocaeicola_A (p < 0.05). Furthermore, TBF, 25-OHD, or their combination reduced the abundance of Faecalibacterium (p < 0.05). These findings suggest that combined TBF and 25-OHD mitigates FLS in laying hens potentially through remodeling gut microbiota and maintaining lipid metabolic homeostasis. Full article

Obesity is currently one of the most critical public health problems. Although there is no doubt that obesity is a significant risk factor for developing metabolic disorders, this relationship is not completely straightforward. On the one hand, some patients affected by obesity are metabolically unhealthy, while others are metabolically healthy; on the other hand, metabolic syndrome (MetS) can also occur in people with a normal body weight. A commonly used tool for diagnosing obesity is the body mass index (BMI), but the search for better anthropometric measures is ongoing due to the significant limitations of this measure. Obesity can lead to MetS and cardiovascular diseases (CVDs). Adipose tissue dysfunction is the fundamental mechanism linking obesity and cardiometabolic diseases, which is rooted in the disturbed secretion of adipokines. The visceral adiposity index (VAI) is calculated based on the BMI, waist circumference (WC), blood triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) concentrations. It was proposed in 2010 by Amato et al. as a parameter indicating adipose tissue dysfunction and cardiometabolic risk. According to the research conducted so far, some data confirm a relationship between the VAI value and the risk of developing prediabetes, diabetes, insulin resistance, fatty liver disease, MetS, CVD, and chronic kidney disease. Further research is needed to support the implementation of VAI assessment in routine clinical practice. The purpose of this paper is to present the results of a narrative literature review summarizing current knowledge regarding the VAI and its usefulness in clinical practice for assessing cardiometabolic risk. Full article

Previously, research adopted an ultrasound-assisted extraction method to isolate crude polysaccharide from blackened jujube, followed by preliminary structural identification of the purified polysaccharide (BJP). This manuscript analyzed the accurate structure and immunomodulatory activity of BJP. Further structural identification indicated that BJP was mainly composed of →3)-α-L-Araf-(1→, →3,5)-α-L-Araf-(1→, →3)-β-D-GalpA-(1→, →2,4)-β-D-Galp-(1→, →4)-β-D-GalpA-(1→, →3)-α-L-Rhap-(1→ and →3,4)-α-L-Rhap-(1→. The immunomodulatory effects of BJP were examined using a mouse model with immunosuppression induced by cyclophosphamide. The findings suggested that BJP could relieve the condition of immunosuppressed mice. BJP could inhibit decreases in the body weight and organ index of mice, and HE staining showed that BJP could alleviate the harm to spleen and thymus tissues. BJP enhanced the secretion of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2), interleukin-6 (IL-6), immunoglobulin A (IgA), and immunoglobulin G (IgG) in serum. It also reduced liver oxidative stress by increasing superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) activities, while lowering malondialdehyde (MDA) levels. Moreover, BJP contributed to the maintenance of gut homeostasis by stimulating the generation of short-chain fatty acids in the cecal contents. The study aims to establish a solid basis for the comprehensive development of blackened jujube and furnish a theoretical framework for its polysaccharides’ role in immune modulation. Full article

Objective: Tumor progression is regulated by systemic immune status, nutritional metabolism, and the inflammatory microenvironment. This study aims to investigate inflammatory–nutritional biomarkers associated with metachronous liver metastasis (MLM) in colorectal cancer (CRC) and develop a machine learning model for accurate prediction. Methods: This study enrolled 680 patients with CRC who underwent curative resection, randomly allocated into a training set (n = 477) and a validation set (n = 203) in a 7:3 ratio. Feature selection was performed using Boruta and Lasso algorithms, identifying nine core prognostic factors through variable intersection. Seven machine learning (ML) models were constructed using the training set, with the optimal predictive model selected based on comprehensive evaluation metrics. An interactive visualization tool was developed to interpret the dynamic impact of key features on individual predictions. The partial dependence plots (PDPs) revealed a potential dose–response relationship between inflammatory–nutritional markers and MLM risk. Results: Among 680 patients with CRC, the cumulative incidence of MLM at 6 months postoperatively was 39.1%. Multimodal feature selection identified nine key predictors, including the N stage, vascular invasion, carcinoembryonic antigen (CEA), systemic immune–inflammation index (SII), albumin–bilirubin index (ALBI), differentiation grade, prognostic nutritional index (PNI), fatty liver, and T stage. The gradient boosting machine (GBM) demonstrated the best overall performance (AUROC: 0.916, sensitivity: 0.772, specificity: 0.871). The generalized additive model (GAM)-fitted SHAP analysis established, for the first time, risk thresholds for four continuous variables (CEA > 8.14 μg/L, PNI < 44.46, SII > 856.36, ALBI > −2.67), confirming their significant association with MLM development. Conclusions: This study developed a GBM model incorporating inflammatory-nutritional biomarkers and clinical features to accurately predict MLM in colorectal cancer. Integrated with dynamic visualization tools, the model enables real-time risk stratification via a freely accessible web calculator, guiding individualized surveillance planning and optimizing clinical decision-making for precision postoperative care. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) causes progressive liver fibrosis. Although erythrocyte mean corpuscular volume (MCV) has been shown to have a positive correlation with all-cause mortality, the association between MCV and the development of MASLD has not been fully elucidated. Here, we examined the clinical significance of the association between MCV and MASLD. Methods: A cross-sectional study was carried out in 1009 Japanese individuals (including 186 individuals aged < 60 years and 823 individuals aged ≥ 60 years) with metabolic disorders. The relationships between MCV and noninvasive clinical markers of liver fibrosis, including fibrosis-4 (FIB-4) index, aspartate aminotransferase-to-platelet ratio index (APRI), and non-alcoholic fatty liver disease (NAFLD) fibrosis score (NFS), were statistically evaluated. Results: Using multiple and logistic regression analyses in overall subjects, it was found that MCV was positively and independently associated with the values of FIB-4 index, APRI, NFS, and the prevalence of liver fibrosis defined by each index. However, the associations between the MCV value and MASLD indices were found to be positive in subjects aged ≥ 60 years but not in those aged < 60 years. Conclusions: MCV might be a simple and useful biomarker for the development of MASLD in the elderly. Full article

Background/Objectives: Metabolic dysfunction-associated fatty liver disease (MAFLD) is linked to cardiovascular complications, including atrial fibrillation. P-wave indices (PWIs) reflect atrial conduction heterogeneity but have not been fully evaluated in MAFLD. To compare PWIs in MAFLD patients versus controls, assess their association with fibrosis severity, and evaluate their diagnostic performance for MAFLD and fibrosis. Methods: In this retrospective single-center study, 447 subjects were included (noMAFLD: Fatty Liver Index (FLI) < 30 without metabolic dysfunction, n = 205; MAFLD: FLI ≥ 60+ ≥ 1 metabolic risk factor, n = 242). Among MAFLD subjects, the non-alcoholic fatty liver disease (NAFLD) Fibrosis Score (NFS) stratified lower (NFS ≤ −1.455; n = 170), and there was a higher fibrosis risk (NFS > −1.455; n = 72). Standard 12-lead ECGs were digitized for offline PWI measurement. Statistical analyzes included group comparisons, multivariable logistic regression, and ROC curve analysis. Results: MAFLD patients exhibited a longer PWPT-D2 (63 ± 12 vs. 52 ± 10 ms, p = 0.003), PWPT-V1 (68 ± 14 vs. 60 ± 13 ms, p = 0.005), PWdis (55 ± 13 vs. 46 ± 11 ms, p = 0.010), and PTFV₁ (38 [31–46] vs. 28 [22–34] mm·ms, p = 0.021) compared with controls. Within MAFLD, a higher fibrosis risk was associated with a further PWI prolongation (all p < 0.015). Multivariate analysis identified PWPT-D2 (OR 1.05 per ms; 95% CI 1.02–1.08; p = 0.002) and PWDIS (OR 1.03 per ms; 95% CI 1.00–1.06; p = 0.048) as independent MAFLD predictors. ROC curves showed PWPT-D2 had the highest AUC for MAFLD detection (0.78; 95% CI 0.72–0.84) and fibrosis (0.82; 95% CI 0.76–0.88). Combining PWPT-D2 with BMI and waist circumference improved MAFLD discrimination (AUC 0.89; 95% CI 0.85–0.93; p < 0.001 vs. PWPT-D2 alone). Conclusions: PWPT-D2 and PWdis are significantly prolonged in MAFLD and more so with advanced fibrosis. PWPT-D2 may be a simple, noninvasive ECG marker for MAFLD screening and fibrosis staging, particularly when combined with anthropometric measures. Full article

Background/Objectives: Hypertension is strongly linked to changes in vascular function and lipid metabolism. This study aimed to examine the relationship between lipid profiles, various metabolic biomarkers, and pulse wave analysis in patients with hypertension. Methods: A group of 66 hypertensive patients, aged 64 ± 10 years, participated in pulse wave analysis utilizing an oscillometric device. Multiple lipid serum biomarkers were assessed, such as total cholesterol (TC), triglycerides (TG), and non-HDL cholesterol (non-HDL). Lipid balance index (LBI) was determined by considering TG, LDL, HDL levels, and lipid-lowering medications. Results: Notable correlations were observed for SBP, DBP, and early vascular aging (EVA) with lipid biomarkers. In addition to serum lipids, metabolic syndrome, insulin resistance, and non-alcoholic fatty liver disease (NAFLD) were significantly linked to pulse wave analysis variables. Multiple regression analysis showed that only TC continued to have a significant association with DBP. Conclusions: Total cholesterol, triglycerides, non-HDL cholesterol, and lipid balance index provide information about systolic and diastolic blood pressure, as well as early vascular aging in hypertensive patients. LBI offers valuable vascular insights in hypertensive individuals with cardiovascular risk factors, early vascular aging, insulin resistance, and NAFLD. The connection between metabolic biomarkers and pulse wave measurements in individuals with hypertension offers a comprehensive method for the early identification of vascular injury and could enhance the prediction of major cardiovascular events. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95% CI: 7.40–8.26) and ZJU (OR: 5.91; 95% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships. Full article

Background/Objectives: Fatty liver disease (FLD) is currently the most common liver disorder, affecting 25–30% of the global population. Its occurrence is strongly associated with overweight, obesity, and type 2 diabetes. In 2020, the disease definition was revised from NAFLD (non-alcoholic fatty liver disease) to MAFLD (metabolic-associated fatty liver disease), emphasizing its link to metabolic dysfunction and marking a major shift in clinical evaluation and risk stratification. We assessed the association between MAFLD and cardiovascular risk factors in a geriatric population by comparing patients with and without fatty liver disease and evaluating the influence of selected metabolic and echocardiographic parameters on MAFLD prevalence. Methods: This retrospective study was conducted using data from patients treated at the Department of Geriatrics, the University Clinical Hospital, in Wrocław. The study included 237 patients diagnosed with fatty liver disease and 148 controls without liver pathology. The groups were compared in terms of comorbidities, laboratory abnormalities, body mass index (BMI), and left ventricular hypertrophy. Statistical analysis was performed to assess the association between the severity of selected variables and the risk of MAFLD. Results: Patients with MAFLD had significantly higher body weight and BMI compared to controls. Diabetes mellitus and hypertriglyceridemia were more frequent in the MAFLD group, whereas HDL and vitamin D3 levels were lower. Echocardiographic indicators of left ventricular hypertrophy [IVSd, LVPWd, (IVSd + LVPWd)/2] were significantly elevated in MAFLD patients. Conclusions: This study confirms a strong association between MAFLD and cardiovascular risk factors in elderly patients. The inclusion of a control group allowed for more precise evaluation, supporting the role of MAFLD as an independent cardiometabolic risk indicator in geriatric care. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common cause of chronic liver disease and is closely associated with metabolic abnormalities and cardiovascular risks. Butyrate, a short-chain fatty acid produced by gut microbiota, has the potential to enhance liver health by modulating inflammation and supporting gut barrier integrity. This study aimed to investigate and compare the effects of sodium butyrate and calcium butyrate in patients with MASLD. In this single-center, randomized clinical trial, 181 patients with MASLD were enrolled and assigned to receive either sodium butyrate (n = 121) or calcium butyrate (n = 60) supplementation at a daily dose of 1000 mg. The primary endpoint was the change in liver steatosis, measured using the Controlled Attenuation Parameter (CAP) via FibroScan^®. Secondary endpoints included liver stiffness, biochemical parameters, hepatic steatosis and fatty liver indices, fecal calprotectin levels, stool short-chain fatty acid levels, and microbiome composition. A subgroup analysis compared responders (a ≥ 5% reduction in CAP) to non-responders. There were no significant changes in CAP values for either group (ΔCAP: sodium butyrate, 0.84; calcium butyrate, −0.23; p = 0.70). Sodium butyrate significantly reduced serum trimethylamine N-oxide and fatty liver index, while calcium butyrate led to a decrease in fecal calprotectin levels. Responders demonstrated a lower body mass index, higher levels of high-sensitivity C-reactive protein and HbA1c, and distinct microbiome profiles, characterized by lower abundance of Subdoligranulum and higher abundance of Catenibacterium. Although butyrate supplementation did not significantly improve liver steatosis as measured by CAP, the differing effects on metabolic and inflammatory markers suggest that there may be potential benefits for specific subgroups of patients with MASLD. Full article

Background: Fatty liver disease (FLD), the most common liver disease worldwide, is associated with cardiometabolic diseases and increases the risk of cardiovascular disease. It remains asymptomatic in its early stages, and late diagnosis heightens the likelihood of progression to severe liver diseases. Objectives: We aimed to evaluate the utility of serum uric acid to HDL cholesterol ratio (UA/HDL-C) as a biomarker for FLD and compare its diagnostic utility versus established liver disease index (FLI, LAP, HSI, NAFLD score (FLS), and ALT/AST ratio). Methods: This cross-sectional study, conducted between 2009 and 2013, included 1470 adults, 50.2% women and 49.8% men between 20 and 75 years old. FLD was diagnosed using non-contrast computed tomography. The population was stratified by sex and FLD. The associations with UA/HDL-C were analyzed using ROC curves and logistic regression analysis to evaluate and compare the predictive capacity of various indices for FLD. Results: Anthropometric, physiologic, biochemical variables, ratios, and indices were significantly higher in subjects with FLD (p < 0.001). In the unadjusted logistic regression model, UA/HDL-C is strongly associated with FLD (co-efficient 2.5, p < 0.001). The FLS, HSI, and ALT/AST ratios were also significant, whereas FLI and LAP showed no clear relationship. In the sex-adjusted model, the UA/HDL-C ratio remained strongly associated with FLD (3.47, p < 0.001). Conclusions: Our results suggest that the UA/HDL-C ratio is associated with FLD as an established liver disease index and may be a practical, useful marker for FLD. The results highlight its potential as a scrutiny and early biomarker for effective preventive strategies for FLD. Full article