An updated systematic review and meta-analysis: correlation between circulating plasminogen activator inhibitor-1 levels and metabolic dysfunction-associated steatotic liver disease

Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease—is the leading cause of chronic liver disease globally. However, early diagnosis and specific treatment have not yet been achieved. Plasminogen activator inhibitor...

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Main Authors: Qicong Li, Yuting Ruan, Yuqing Zhu, Yingying Cai, Kaihan Wu, Chenglu Shen, Qin Zhang, Shuaihang Chen, Jie Hu, Shan Liu, Miaojuan Wang
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-04148-8
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author Qicong Li
Yuting Ruan
Yuqing Zhu
Yingying Cai
Kaihan Wu
Chenglu Shen
Qin Zhang
Shuaihang Chen
Jie Hu
Shan Liu
Miaojuan Wang
author_facet Qicong Li
Yuting Ruan
Yuqing Zhu
Yingying Cai
Kaihan Wu
Chenglu Shen
Qin Zhang
Shuaihang Chen
Jie Hu
Shan Liu
Miaojuan Wang
author_sort Qicong Li
collection DOAJ
description Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease—is the leading cause of chronic liver disease globally. However, early diagnosis and specific treatment have not yet been achieved. Plasminogen activator inhibitor-1 (PAI-1) is closely related to MASLD and may be an important indicator for its diagnosis and treatment. This updated meta-analysis aimed to comprehensively explore the relationship between circulating PAI-1 levels and MASLD. Methods Article retrieval was carried out in seven provenances (PubMed, Cochrane Library, EMBASE, CNKI, WANFANG, Clinical Trials Database, and Grey Literature Database) using free text words and MeSH terms. The meta-analysis was performed using RevMan 5.3 and Stata 12. Outcomes were presented as standardised mean difference (SMD) with 95% confidence intervals (CI). Results A total of 23 studies were included in the meta-analysis. The levels of circulating PAI-1 in patients with MASLD were significantly higher than those in healthy controls (SMD = 1.44, 95% CI [1.06, 1.83]). Subgroup and meta-regression analyses based on key factors, such as area, age, and BMI, were performed to explore the sources of heterogeneity. In the BMI subgroup analysis, the participants were divided into two groups. While the subgroup results were inconclusive, the meta-regression suggested that the area (i.e. the geographic region of the study population) may be a major contributor to heterogeneity (p < 0.001). Conclusions Patients with MASLD have significantly high circulating PAI-1 levels; however, this correlation may vary in different regions, thereby providing a reference for further research on MASLD.
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spelling doaj-art-7552f999666143d591936a7813902d132025-08-24T11:32:55ZengBMCBMC Gastroenterology1471-230X2025-08-0125111310.1186/s12876-025-04148-8An updated systematic review and meta-analysis: correlation between circulating plasminogen activator inhibitor-1 levels and metabolic dysfunction-associated steatotic liver diseaseQicong Li0Yuting Ruan1Yuqing Zhu2Yingying Cai3Kaihan Wu4Chenglu Shen5Qin Zhang6Shuaihang Chen7Jie Hu8Shan Liu9Miaojuan Wang10The First Clinical Medical College of Zhejiang Chinese Medical UniversityThe First Clinical Medical College of Zhejiang Chinese Medical UniversityThe First Clinical Medical College of Zhejiang Chinese Medical UniversityThe Third Clinical Medical College of Zhejiang Chinese Medical UniversityThe First Clinical Medical College of Zhejiang Chinese Medical UniversityThe First Clinical Medical College of Zhejiang Chinese Medical UniversityThe First Clinical Medical College of Zhejiang Chinese Medical UniversityThe Second Clinical Medical College of Zhejiang Chinese Medical UniversityDepartment of Infectious Diseases, The First Affiliated Hospital of Zhejiang Chinese Medical UniversityCenter of Clinical Evaluation, The First Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of General Practice, The First Affiliated Hospital of Zhejiang Chinese Medical UniversityAbstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease—is the leading cause of chronic liver disease globally. However, early diagnosis and specific treatment have not yet been achieved. Plasminogen activator inhibitor-1 (PAI-1) is closely related to MASLD and may be an important indicator for its diagnosis and treatment. This updated meta-analysis aimed to comprehensively explore the relationship between circulating PAI-1 levels and MASLD. Methods Article retrieval was carried out in seven provenances (PubMed, Cochrane Library, EMBASE, CNKI, WANFANG, Clinical Trials Database, and Grey Literature Database) using free text words and MeSH terms. The meta-analysis was performed using RevMan 5.3 and Stata 12. Outcomes were presented as standardised mean difference (SMD) with 95% confidence intervals (CI). Results A total of 23 studies were included in the meta-analysis. The levels of circulating PAI-1 in patients with MASLD were significantly higher than those in healthy controls (SMD = 1.44, 95% CI [1.06, 1.83]). Subgroup and meta-regression analyses based on key factors, such as area, age, and BMI, were performed to explore the sources of heterogeneity. In the BMI subgroup analysis, the participants were divided into two groups. While the subgroup results were inconclusive, the meta-regression suggested that the area (i.e. the geographic region of the study population) may be a major contributor to heterogeneity (p < 0.001). Conclusions Patients with MASLD have significantly high circulating PAI-1 levels; however, this correlation may vary in different regions, thereby providing a reference for further research on MASLD.https://doi.org/10.1186/s12876-025-04148-8Metabolic dysfunction-associated steatotic liver diseaseNon-alcoholic fatty liver diseasePlasminogen activator inhibitor-1Meta-analysis
spellingShingle Qicong Li
Yuting Ruan
Yuqing Zhu
Yingying Cai
Kaihan Wu
Chenglu Shen
Qin Zhang
Shuaihang Chen
Jie Hu
Shan Liu
Miaojuan Wang
An updated systematic review and meta-analysis: correlation between circulating plasminogen activator inhibitor-1 levels and metabolic dysfunction-associated steatotic liver disease
BMC Gastroenterology
Metabolic dysfunction-associated steatotic liver disease
Non-alcoholic fatty liver disease
Plasminogen activator inhibitor-1
Meta-analysis
title An updated systematic review and meta-analysis: correlation between circulating plasminogen activator inhibitor-1 levels and metabolic dysfunction-associated steatotic liver disease
title_full An updated systematic review and meta-analysis: correlation between circulating plasminogen activator inhibitor-1 levels and metabolic dysfunction-associated steatotic liver disease
title_fullStr An updated systematic review and meta-analysis: correlation between circulating plasminogen activator inhibitor-1 levels and metabolic dysfunction-associated steatotic liver disease
title_full_unstemmed An updated systematic review and meta-analysis: correlation between circulating plasminogen activator inhibitor-1 levels and metabolic dysfunction-associated steatotic liver disease
title_short An updated systematic review and meta-analysis: correlation between circulating plasminogen activator inhibitor-1 levels and metabolic dysfunction-associated steatotic liver disease
title_sort updated systematic review and meta analysis correlation between circulating plasminogen activator inhibitor 1 levels and metabolic dysfunction associated steatotic liver disease
topic Metabolic dysfunction-associated steatotic liver disease
Non-alcoholic fatty liver disease
Plasminogen activator inhibitor-1
Meta-analysis
url https://doi.org/10.1186/s12876-025-04148-8
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