Liver steatosis is positively associated with plasminogen activator inhibitor-1 in apparently healthy individuals with overweight and obesity: A FibroScan-Based Cross-Sectional study

Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common cause of steatotic liver disease and has major implications on cardiovascular safety. Study aims As the precise role linking MASLD to cardiovascular diseases is still unclear, the present study ai...

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Main Authors: Giuseppe Lisco, Davide Guido, Nicole Cerabino, Martina Di Chito, Rosanna Donvito, Caterina Bonfiglio, Endrit Shahini, Marianna Zappimbulso, Cristiana Randazzo, Domenico Barletta, Dolores Stabile, Anna Ancona, Sergio Coletta, Pasqua Letizia Pesole, Gianluigi Giannelli, Giovanni De Pergola
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Journal of Translational Medicine
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Online Access:https://doi.org/10.1186/s12967-025-06464-9
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author Giuseppe Lisco
Davide Guido
Nicole Cerabino
Martina Di Chito
Rosanna Donvito
Caterina Bonfiglio
Endrit Shahini
Marianna Zappimbulso
Cristiana Randazzo
Domenico Barletta
Dolores Stabile
Anna Ancona
Sergio Coletta
Pasqua Letizia Pesole
Gianluigi Giannelli
Giovanni De Pergola
author_facet Giuseppe Lisco
Davide Guido
Nicole Cerabino
Martina Di Chito
Rosanna Donvito
Caterina Bonfiglio
Endrit Shahini
Marianna Zappimbulso
Cristiana Randazzo
Domenico Barletta
Dolores Stabile
Anna Ancona
Sergio Coletta
Pasqua Letizia Pesole
Gianluigi Giannelli
Giovanni De Pergola
author_sort Giuseppe Lisco
collection DOAJ
description Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common cause of steatotic liver disease and has major implications on cardiovascular safety. Study aims As the precise role linking MASLD to cardiovascular diseases is still unclear, the present study aims to investigate the association between liver steatosis and fibrosis and circulating plasminogen activator inhibitor-1 (PAI-1) levels. Methods Eighty-two patients (41.6 ± 12.4 yrs, 34 men, 41%), naïve to medications, who attended the Nutrition Center for the Research and Care of Obesity and Metabolic Diseases at the National Institute of Gastroenterology “Saverio de Bellis” for weight management, were cross-sectionally evaluated. Demographic, anthropometric, clinic, and laboratory data were collected and analyzed. All patients underwent liver ultrasonographic assessment by FibroScan to diagnose liver steatosis (controlled attenuation parameter or CAP > 275 dBm) and fibrosis (liver stiffness > 8.2 kPa). Results Sixty-one individuals (74.4%) had liver steatosis, and 17 (20.7%) had liver fibrosis. PAI-1 mean levels were 3,261 ± 1,270 pg/mL, mean body mass index (BMI) and waist circumference (WC) values were 36.6 ± 7.1 kg/m2 and 114.1 ± 16.5 cm, respectively. Mild systolic and diastolic arterial pressure elevation and significantly high values of fasting plasma insulin (19.6 ± 12.6 IU/mL) and homeostatic model assessment of insulin resistance or HOMA-IR (4.8 ± 3.5) were also found. CAP values were correlated with several anthropometric, clinical, and laboratory parameters of insulin resistance. We found a significant association between PAI-1 and CAP (β = 1.605; p = 0.004), and noteworthily, when PAI-1 increased by 100 units, the expected variation of CAP values was by + 1.6 units (p = 0.004). Notably, the association was independent of gender, age, and insulin resistance. Discussion Circulating PAI-1 levels are correlated with liver steatosis and, to a lesser extent, fibrosis in apparently healthy patients with a BMI ≥ 25 kg/m2. This is the first study to show these results in patients naïve to medications, using FibroScan assessment. The bidirectional relationship between circulating PAI-1 levels and CAP measurement highlights the relevance of our research from a diagnostic and pathophysiological-prognostic viewpoint. Longitudinal trials are needed to clarify the cause-effect association between MASLD and PAI-1 levels.
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spelling doaj-art-2b31b959a17d4f57bab517db4f1f1bfa2025-08-20T02:10:49ZengBMCJournal of Translational Medicine1479-58762025-04-0123111010.1186/s12967-025-06464-9Liver steatosis is positively associated with plasminogen activator inhibitor-1 in apparently healthy individuals with overweight and obesity: A FibroScan-Based Cross-Sectional studyGiuseppe Lisco0Davide Guido1Nicole Cerabino2Martina Di Chito3Rosanna Donvito4Caterina Bonfiglio5Endrit Shahini6Marianna Zappimbulso7Cristiana Randazzo8Domenico Barletta9Dolores Stabile10Anna Ancona11Sergio Coletta12Pasqua Letizia Pesole13Gianluigi Giannelli14Giovanni De Pergola15Interdisciplinary Department of Medicine, School of Medicine, University of Bari “Aldo Moro”Unit of Data Science, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS HospitalCenter of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”Unit of Data Science, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS HospitalDepartment of Gastroenterology, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS HospitalDepartment of Gastroenterology, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS HospitalDipartimento di Promozione della Salute, Medicina Interna e Specialistica di Eccellenza (PROMISE), Materno-Infantile, University of PalermoLaboratory of Clinical Pathology, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS HospitalCore Facility Biobank, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS HospitalCore Facility Biobank, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS HospitalCore Facility Biobank, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS HospitalCore Facility Biobank, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS HospitalScientific Direction, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS HospitalCenter of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common cause of steatotic liver disease and has major implications on cardiovascular safety. Study aims As the precise role linking MASLD to cardiovascular diseases is still unclear, the present study aims to investigate the association between liver steatosis and fibrosis and circulating plasminogen activator inhibitor-1 (PAI-1) levels. Methods Eighty-two patients (41.6 ± 12.4 yrs, 34 men, 41%), naïve to medications, who attended the Nutrition Center for the Research and Care of Obesity and Metabolic Diseases at the National Institute of Gastroenterology “Saverio de Bellis” for weight management, were cross-sectionally evaluated. Demographic, anthropometric, clinic, and laboratory data were collected and analyzed. All patients underwent liver ultrasonographic assessment by FibroScan to diagnose liver steatosis (controlled attenuation parameter or CAP > 275 dBm) and fibrosis (liver stiffness > 8.2 kPa). Results Sixty-one individuals (74.4%) had liver steatosis, and 17 (20.7%) had liver fibrosis. PAI-1 mean levels were 3,261 ± 1,270 pg/mL, mean body mass index (BMI) and waist circumference (WC) values were 36.6 ± 7.1 kg/m2 and 114.1 ± 16.5 cm, respectively. Mild systolic and diastolic arterial pressure elevation and significantly high values of fasting plasma insulin (19.6 ± 12.6 IU/mL) and homeostatic model assessment of insulin resistance or HOMA-IR (4.8 ± 3.5) were also found. CAP values were correlated with several anthropometric, clinical, and laboratory parameters of insulin resistance. We found a significant association between PAI-1 and CAP (β = 1.605; p = 0.004), and noteworthily, when PAI-1 increased by 100 units, the expected variation of CAP values was by + 1.6 units (p = 0.004). Notably, the association was independent of gender, age, and insulin resistance. Discussion Circulating PAI-1 levels are correlated with liver steatosis and, to a lesser extent, fibrosis in apparently healthy patients with a BMI ≥ 25 kg/m2. This is the first study to show these results in patients naïve to medications, using FibroScan assessment. The bidirectional relationship between circulating PAI-1 levels and CAP measurement highlights the relevance of our research from a diagnostic and pathophysiological-prognostic viewpoint. Longitudinal trials are needed to clarify the cause-effect association between MASLD and PAI-1 levels.https://doi.org/10.1186/s12967-025-06464-9ObesityOverweightLiver steatosisLiver fibrosisFibroscanPAI-1
spellingShingle Giuseppe Lisco
Davide Guido
Nicole Cerabino
Martina Di Chito
Rosanna Donvito
Caterina Bonfiglio
Endrit Shahini
Marianna Zappimbulso
Cristiana Randazzo
Domenico Barletta
Dolores Stabile
Anna Ancona
Sergio Coletta
Pasqua Letizia Pesole
Gianluigi Giannelli
Giovanni De Pergola
Liver steatosis is positively associated with plasminogen activator inhibitor-1 in apparently healthy individuals with overweight and obesity: A FibroScan-Based Cross-Sectional study
Journal of Translational Medicine
Obesity
Overweight
Liver steatosis
Liver fibrosis
Fibroscan
PAI-1
title Liver steatosis is positively associated with plasminogen activator inhibitor-1 in apparently healthy individuals with overweight and obesity: A FibroScan-Based Cross-Sectional study
title_full Liver steatosis is positively associated with plasminogen activator inhibitor-1 in apparently healthy individuals with overweight and obesity: A FibroScan-Based Cross-Sectional study
title_fullStr Liver steatosis is positively associated with plasminogen activator inhibitor-1 in apparently healthy individuals with overweight and obesity: A FibroScan-Based Cross-Sectional study
title_full_unstemmed Liver steatosis is positively associated with plasminogen activator inhibitor-1 in apparently healthy individuals with overweight and obesity: A FibroScan-Based Cross-Sectional study
title_short Liver steatosis is positively associated with plasminogen activator inhibitor-1 in apparently healthy individuals with overweight and obesity: A FibroScan-Based Cross-Sectional study
title_sort liver steatosis is positively associated with plasminogen activator inhibitor 1 in apparently healthy individuals with overweight and obesity a fibroscan based cross sectional study
topic Obesity
Overweight
Liver steatosis
Liver fibrosis
Fibroscan
PAI-1
url https://doi.org/10.1186/s12967-025-06464-9
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