Multiparametric ultrasound for non-invasive assessment of liver steatosis, fibrosis, and inflammation in metabolic dysfunction-associated steatotic liver disease

Table 1 Demographic, clinical, histological and biochemical characteristics of the enrolled patients

Characteristic	Entire cohort (n = 120)	No MASH (n = 39)	MASH (n = 81)	P value
Sex (male)	68 (56.7)	24 (61.5)	44 (54.3)	NS
Age (years)	49 ± 11	50 ± 10	49 ± 11	NS
BMI (kg/m2)	33.2 ± 7.1	31.7 ± 6.9	34.0 ± 7.1	NS
Obesity	72 (60.0)	19 (48.7)	53 (65.4)	0.08
Diabetes	35 (29.1)	7 (17.9)	28 (34.5)	0.06
Hypertension	54 (45.0)	14 (35.9)	40 (49.4)	NS
Biochemical profile
Platelet count (× 106/mL)	230.9 ± 68.2	230.6 ± 59.0	231.0 ± 72.6	NS
AST (IU/L)	43.7 ± 38.9	32.3 ± 14.3	49.3 ± 45.3	0.02
ALT (IU/L)	59.2 ± 50.2	42.4 ± 23.9	67.2 ± 57.2	0.01
GGT (IU/L)	65.7 ± 56.2	68.6 ± 73.2	64.3 ± 47.3	NS
ALP (IU/L)	74.7 ± 37.1	85.7 ± 52.6	69.6 ± 25.9	0.03
Albumin (g/L)	40.9 ± 3.5	41.6 ± 3.2	40.5 ± 3.5	NS
Triglycerides (mg/dL)	157.9 ± 90.6	137.5 ± 53.7	168.0 ± 103.1	NS
Total cholesterol (mg/dL)	196.3 ± 44.2	195.9 ± 42.0	196.5 ± 45.5	NS
HDL (mg/dL)	44.7 ± 14.3	50.1 ± 22.5	42.7 ± 8.8	0.04
FIB4	1.54 ± 2.67	1.20 ± 0.61	1.71 ± 3.22	NS
NFS	-1.24 ± 1.71	-1.54 ± 1.48	-1.10 ± 1.80	NS
Agile3 +	0.14 (0.06-0.53)	0.11 (0.05-0.33)	0.23 (0.06-0.60)	0.02
Histological findings
Steatosis grade				< 0.01
1	47 (39.2)	39 (100)	8 (9.9)
2	49 (40.8)	0 (0)	49 (60.5)
3	24 (20.0)	0 (0)	24 (29.6)
Lobular inflammation grade				< 0.01
0	4 (3.3)	4 (10.2)	0 (0)
1	90 (75.0)	35 (89.8)	55 (67.9)
2	24 (20.0)	0 (0)	24 (29.6)
3	2 (1.7)	0 (0)	2 (2.5)
Hepatocyte ballooning grade				< 0.01
0	13 (10.8)	13 (33.3)	0 (0)
1	94 (78.4)	26 (66.6)	68 (84.2)
2	13 (10.8)	0 (0)	13 (15.8)
Fibrosis stage				0.01
0	3 (2.5)	3 (7.7)	0 (0)
1	43 (35.8)	19 (48.8)	24 (29.6)
2	40 (33.3)	12 (30.7)	28 (34.6)
3	30 (25.0)	4 (10.2)	26 (32.1)
4	4 (3.4)	1 (2.6)	3 (3.7)
Elastographic measurements
LS by TE (kPa)	7.9 ± 5.0	6.2 ± 3.2	8.7 ± 5.3	0.01
2D-SWE (kPa)	7.34 ± 3.16	6.61 ± 3.02	7.70 ± 3.19	0.07
CAP (dB/m)	302.9 ± 67.2	250.5 ± 74.5	328.2 ± 45.9	< 0.01
Att.PLUS (dB/cm/mHz)	0.52 ± 0.11	0.55 ± 0.12	0.51 ± 0.10	0.06
SSp.PLUS (m/s)	1530 (1505-1550)	1545 (1525-1570)	1525 (1500-1545)	< 0.01
Vi.PLUS (Pa.s)	2.24 ± 0.51	2.04 ± 0.54	2.34 ± 0.48	0.03

Data are presented as mean ± SD or n (%). MASH: Metabolic dysfunction-associated steatohepatitis; BMI: Body mass index; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; GGT: Gamma-glutamyl transferase; ALP: Alkaline phosphatase; HDL: High-density lipoprotein; FIB: Fibrosis; NFS: Nonalcoholic fatty liver disease fibrosis score; LS: Liver stiffness; TE: Transient elastography; Att.PLUS: Attenuation plane-wave ultrasound; SSp.PLUS: Sound speed plane-wave ultrasound; 2D-SWE: Two-dimensional shear wave elastography; CAP: Controlled attenuation parameter; Vi.PLUS: Viscosity plane-wave ultrasound; NS: Not significant.