Non-invasive detection of fibrosis in non-alcoholic fatty liver disease by serum microfibrillar-associated protein 4 and its correlation with FIB-4 and transient elastography

Abstract Background and study aim The accumulation of macrovesicular hepatic lipids in persons who drink little or no alcohol is called non-alcoholic fatty liver disease (NAFLD), which is a clinicopathological liver condition that involves a range of fatty liver abnormalities from hepatic steatosis...

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Main Authors: Heba Abdel Rahman Eltony, Gamal Kasem, Radwa Mahmoud Elsharaby, Rehab Badawi, Eman M. Helal
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:Egyptian Liver Journal
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Online Access:https://doi.org/10.1186/s43066-025-00439-7
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author Heba Abdel Rahman Eltony
Gamal Kasem
Radwa Mahmoud Elsharaby
Rehab Badawi
Eman M. Helal
author_facet Heba Abdel Rahman Eltony
Gamal Kasem
Radwa Mahmoud Elsharaby
Rehab Badawi
Eman M. Helal
author_sort Heba Abdel Rahman Eltony
collection DOAJ
description Abstract Background and study aim The accumulation of macrovesicular hepatic lipids in persons who drink little or no alcohol is called non-alcoholic fatty liver disease (NAFLD), which is a clinicopathological liver condition that involves a range of fatty liver abnormalities from hepatic steatosis to non-alcoholic steatohepatitis, which can evolve to liver fibrosis and advanced cirrhosis that may lead to liver cell failure and, eventually, hepatocellular carcinoma. In this study, we examined fibrosis in NAFLD patients non-invasively by using serum microfibrillar-associated protein 4, and we correlated it with the fibrosis-4 score and transient elastography. Patients and methods This cross-sectional study was conducted on 90 subjects ≥ 18 years. The participants were classified into Group 1 (study group) consisted of 70 patients with NAFLD diagnosed by bright liver on ultrasound, then controlled attenuation parameter determination of liver steatosis > 240 dB/m, and Group 2 (control group) consisted of 20 healthy participants without NAFLD. FIB–4 and NAFLD Fibrosis Score were measured, and MFAP4 was measured by ELISA. Results MFAP4 was significantly higher in NAFLD than in the control. FIB–4, NAFLD fibrosis score, and MFAP4 were significantly higher in the F3 + F4 group compared to the F1 + F2 group. And MFAP4 was positively correlated with FIB–4 and fibrosis grade. Univariate analysis was done to detect the risk factors for increased MFAP4 in NAFLD patients and showed that the increase of weight, body mass index, 2-h postprandial glucose, fibrosis-4, NAFLD Fibrosis Score, fibrosis score and steatosis score by transient elastography were risk factors in those patients. While multivariate analysis found that fibrosis score was the only independent risk factor that increased MFAP4 in those patients. Conclusions According to this study, serum MFAP4 is increased in NAFLD patients and may be used in conjunction with FIB 4 as a biomarker to screen for advanced liver fibrosis and cirrhosis in NAFLD.
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spelling doaj-art-1ff3ca3952fa4f809f30fc6ec44065cf2025-08-20T04:01:46ZengSpringerOpenEgyptian Liver Journal2090-62262025-07-0115111410.1186/s43066-025-00439-7Non-invasive detection of fibrosis in non-alcoholic fatty liver disease by serum microfibrillar-associated protein 4 and its correlation with FIB-4 and transient elastographyHeba Abdel Rahman Eltony0Gamal Kasem1Radwa Mahmoud Elsharaby2Rehab Badawi3Eman M. Helal4Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta UniversityDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta UniversityClinical Pathology Department, Faculty of Medicine, Tanta UniversityDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta UniversityDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta UniversityAbstract Background and study aim The accumulation of macrovesicular hepatic lipids in persons who drink little or no alcohol is called non-alcoholic fatty liver disease (NAFLD), which is a clinicopathological liver condition that involves a range of fatty liver abnormalities from hepatic steatosis to non-alcoholic steatohepatitis, which can evolve to liver fibrosis and advanced cirrhosis that may lead to liver cell failure and, eventually, hepatocellular carcinoma. In this study, we examined fibrosis in NAFLD patients non-invasively by using serum microfibrillar-associated protein 4, and we correlated it with the fibrosis-4 score and transient elastography. Patients and methods This cross-sectional study was conducted on 90 subjects ≥ 18 years. The participants were classified into Group 1 (study group) consisted of 70 patients with NAFLD diagnosed by bright liver on ultrasound, then controlled attenuation parameter determination of liver steatosis > 240 dB/m, and Group 2 (control group) consisted of 20 healthy participants without NAFLD. FIB–4 and NAFLD Fibrosis Score were measured, and MFAP4 was measured by ELISA. Results MFAP4 was significantly higher in NAFLD than in the control. FIB–4, NAFLD fibrosis score, and MFAP4 were significantly higher in the F3 + F4 group compared to the F1 + F2 group. And MFAP4 was positively correlated with FIB–4 and fibrosis grade. Univariate analysis was done to detect the risk factors for increased MFAP4 in NAFLD patients and showed that the increase of weight, body mass index, 2-h postprandial glucose, fibrosis-4, NAFLD Fibrosis Score, fibrosis score and steatosis score by transient elastography were risk factors in those patients. While multivariate analysis found that fibrosis score was the only independent risk factor that increased MFAP4 in those patients. Conclusions According to this study, serum MFAP4 is increased in NAFLD patients and may be used in conjunction with FIB 4 as a biomarker to screen for advanced liver fibrosis and cirrhosis in NAFLD.https://doi.org/10.1186/s43066-025-00439-7Non-Alcoholic Fatty Liver DiseaseSerum Microfibrillar-Associated Protein 4Fibrosis 4 scoreTransient Elastography
spellingShingle Heba Abdel Rahman Eltony
Gamal Kasem
Radwa Mahmoud Elsharaby
Rehab Badawi
Eman M. Helal
Non-invasive detection of fibrosis in non-alcoholic fatty liver disease by serum microfibrillar-associated protein 4 and its correlation with FIB-4 and transient elastography
Egyptian Liver Journal
Non-Alcoholic Fatty Liver Disease
Serum Microfibrillar-Associated Protein 4
Fibrosis 4 score
Transient Elastography
title Non-invasive detection of fibrosis in non-alcoholic fatty liver disease by serum microfibrillar-associated protein 4 and its correlation with FIB-4 and transient elastography
title_full Non-invasive detection of fibrosis in non-alcoholic fatty liver disease by serum microfibrillar-associated protein 4 and its correlation with FIB-4 and transient elastography
title_fullStr Non-invasive detection of fibrosis in non-alcoholic fatty liver disease by serum microfibrillar-associated protein 4 and its correlation with FIB-4 and transient elastography
title_full_unstemmed Non-invasive detection of fibrosis in non-alcoholic fatty liver disease by serum microfibrillar-associated protein 4 and its correlation with FIB-4 and transient elastography
title_short Non-invasive detection of fibrosis in non-alcoholic fatty liver disease by serum microfibrillar-associated protein 4 and its correlation with FIB-4 and transient elastography
title_sort non invasive detection of fibrosis in non alcoholic fatty liver disease by serum microfibrillar associated protein 4 and its correlation with fib 4 and transient elastography
topic Non-Alcoholic Fatty Liver Disease
Serum Microfibrillar-Associated Protein 4
Fibrosis 4 score
Transient Elastography
url https://doi.org/10.1186/s43066-025-00439-7
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