High sensitivity C-reactive protein implicates heterogeneous metabolic phenotypes and severity in metabolic dysfunction associated-steatotic liver disease

Abstract Background Whether include high-sensitivity C-reactive protein (Hs-CRP) in diagnostic flow remains debatable during the updated definition to metabolic dysfunction-associated steatotic liver disease (MASLD) despite systemic inflammation contributes to the disease development and progression...

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Main Authors: Hao Wang, Junzhao Ye, Youpeng Chen, Yanhong Sun, Xiaorong Gong, Hong Deng, Zhiyong Dong, Lishu Xu, Xin Li, Bihui Zhong
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03778-2
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author Hao Wang
Junzhao Ye
Youpeng Chen
Yanhong Sun
Xiaorong Gong
Hong Deng
Zhiyong Dong
Lishu Xu
Xin Li
Bihui Zhong
author_facet Hao Wang
Junzhao Ye
Youpeng Chen
Yanhong Sun
Xiaorong Gong
Hong Deng
Zhiyong Dong
Lishu Xu
Xin Li
Bihui Zhong
author_sort Hao Wang
collection DOAJ
description Abstract Background Whether include high-sensitivity C-reactive protein (Hs-CRP) in diagnostic flow remains debatable during the updated definition to metabolic dysfunction-associated steatotic liver disease (MASLD) despite systemic inflammation contributes to the disease development and progression. We aimed to identify values of hs-CRP compared to other inflammatory markers derived from routine blood tests in MASLD. Materials and methods This cross-sectional study included consecutive participants (ultrasound-diagnosed MASLD: 1,006, healthy controls: 582), and 175 patients received liver biopsy., with 733 and 310 patients underwent magnetic resonance imaging proton density fat fraction for liver fat content (LFC) quantification and two-dimensional shear-wave elastography liver stiffness measurements (LSM), respectively. Results Multiple linear regression analysis revealed a significant positive association between hs-CRP and LFC among overweight/obesity group patients (β 0.19, P = 0.03), and LSM among lean/normal weight group (β 0.30, P < 0.001). For the metabolic dysfunction-associated steatohepatitis (MASH), the hs-CRP and the ratio of monocytes to high-density lipoprotein both performed well in the overweight/obesity group and type 2 diabetes group (Overweight/obesity group, hs-CPR AUC 0.65 and 0.74, P = 0.02), bu no valuable inflammatory indicators were observed in MASH and liver fibrosis. Conclusion Hs-CRP levels are associated with LFC in overweight/obese MASLD and liver stiffness in lean MASLD patients, yet the reported AUC values suggest weak predictive ability. Trial registration The study protocol was registered at the Chinese Clinical Trial Registry, (ChiCTR-ChiCTR2000034197), approved by the First Affiliated Hospital of Sun Yat-sen University institutional with the regional medical ethics committees (Approval number: [2020] No. 187), and performed in accordance with the ethical standards of the 1964 Declaration of Helsinki. Written informed consent was obtained from all the patients.
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spelling doaj-art-3b7953f4389742df9ec1cdc45779f8fe2025-08-20T03:06:57ZengBMCBMC Gastroenterology1471-230X2025-04-0125111310.1186/s12876-025-03778-2High sensitivity C-reactive protein implicates heterogeneous metabolic phenotypes and severity in metabolic dysfunction associated-steatotic liver diseaseHao Wang0Junzhao Ye1Youpeng Chen2Yanhong Sun3Xiaorong Gong4Hong Deng5Zhiyong Dong6Lishu Xu7Xin Li8Bihui Zhong9Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, Yuexiu DistrictDepartment of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, Yuexiu DistrictDepartment of Infectious Diseases, The Seventh Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Clinical Laboratory, The East Division of the First Affiliated Hospital, Sun Yat-Sen UniversityDepartment of Gastroenterology, First Affiliated Hospital, Guangzhou Medical UniversityDepartment of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-Sen UniversityThe First Affiliated Hospital of Jinan UniversityDepartment of Gastroenterology and Hepatology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, and Guangdong Provincial Geriatrics InstituteDepartment of Gastroenterology, The Tenth Affiliated of Southern Medical University (Dongguan People’S Hospital)Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, Yuexiu DistrictAbstract Background Whether include high-sensitivity C-reactive protein (Hs-CRP) in diagnostic flow remains debatable during the updated definition to metabolic dysfunction-associated steatotic liver disease (MASLD) despite systemic inflammation contributes to the disease development and progression. We aimed to identify values of hs-CRP compared to other inflammatory markers derived from routine blood tests in MASLD. Materials and methods This cross-sectional study included consecutive participants (ultrasound-diagnosed MASLD: 1,006, healthy controls: 582), and 175 patients received liver biopsy., with 733 and 310 patients underwent magnetic resonance imaging proton density fat fraction for liver fat content (LFC) quantification and two-dimensional shear-wave elastography liver stiffness measurements (LSM), respectively. Results Multiple linear regression analysis revealed a significant positive association between hs-CRP and LFC among overweight/obesity group patients (β 0.19, P = 0.03), and LSM among lean/normal weight group (β 0.30, P < 0.001). For the metabolic dysfunction-associated steatohepatitis (MASH), the hs-CRP and the ratio of monocytes to high-density lipoprotein both performed well in the overweight/obesity group and type 2 diabetes group (Overweight/obesity group, hs-CPR AUC 0.65 and 0.74, P = 0.02), bu no valuable inflammatory indicators were observed in MASH and liver fibrosis. Conclusion Hs-CRP levels are associated with LFC in overweight/obese MASLD and liver stiffness in lean MASLD patients, yet the reported AUC values suggest weak predictive ability. Trial registration The study protocol was registered at the Chinese Clinical Trial Registry, (ChiCTR-ChiCTR2000034197), approved by the First Affiliated Hospital of Sun Yat-sen University institutional with the regional medical ethics committees (Approval number: [2020] No. 187), and performed in accordance with the ethical standards of the 1964 Declaration of Helsinki. Written informed consent was obtained from all the patients.https://doi.org/10.1186/s12876-025-03778-2Metabolic dysfunction-associated steatotic liver diseaseHigh-sensitive C-reactive proteinInflammationLiver biopsy
spellingShingle Hao Wang
Junzhao Ye
Youpeng Chen
Yanhong Sun
Xiaorong Gong
Hong Deng
Zhiyong Dong
Lishu Xu
Xin Li
Bihui Zhong
High sensitivity C-reactive protein implicates heterogeneous metabolic phenotypes and severity in metabolic dysfunction associated-steatotic liver disease
BMC Gastroenterology
Metabolic dysfunction-associated steatotic liver disease
High-sensitive C-reactive protein
Inflammation
Liver biopsy
title High sensitivity C-reactive protein implicates heterogeneous metabolic phenotypes and severity in metabolic dysfunction associated-steatotic liver disease
title_full High sensitivity C-reactive protein implicates heterogeneous metabolic phenotypes and severity in metabolic dysfunction associated-steatotic liver disease
title_fullStr High sensitivity C-reactive protein implicates heterogeneous metabolic phenotypes and severity in metabolic dysfunction associated-steatotic liver disease
title_full_unstemmed High sensitivity C-reactive protein implicates heterogeneous metabolic phenotypes and severity in metabolic dysfunction associated-steatotic liver disease
title_short High sensitivity C-reactive protein implicates heterogeneous metabolic phenotypes and severity in metabolic dysfunction associated-steatotic liver disease
title_sort high sensitivity c reactive protein implicates heterogeneous metabolic phenotypes and severity in metabolic dysfunction associated steatotic liver disease
topic Metabolic dysfunction-associated steatotic liver disease
High-sensitive C-reactive protein
Inflammation
Liver biopsy
url https://doi.org/10.1186/s12876-025-03778-2
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