Metabolic puzzle: Exploring liver fibrosis differences in Asian metabolic-associated fatty liver disease subtypes

Table 1 Demographic, clinical, and laboratory characteristics of metabolic-associated fatty liver disease patients with different metabolic conditions

Characteristic	Total (n = 322)	No MAFLD(n = 49)	MAFLD (n = 273)			P value
			Single condition (n = 110; 40.3%)	Two conditions (n = 129; 47.3%)	Three conditions (n = 34; 12.5%)	Overall	Single vs two	Single vs three	Two vs three
Age (yr)	44.84 ± 11	42.69 ± 12	44.13 ± 10.47	45.53 ± 10.80	47.65 ± 10.32	0.332	0.474	0.138	0.321
BMI (kg/m2)	29.83 ± 5.53	34.38 ± 2.20	28.99 ± 5.19	31.63 ± 5.19	33.59 ± 4.75	< 0.001	< 0.001	< 0.001	0.064
Female gender (%)	232 (72)	32 (65.3)	85 (77.3)	94 (72.9)	21 (61.8)	0.201	0.434	0.073	0.206
Hypertension (%)	31 (9.6)	5 (10.2)	14 (12.7)	12 (9.3)	0 (0.0)	0.086	0.397	0.029	0.065
Diabetes (%)	96 (29.8)	0 (0)	15 (13.6)	47 (36.4)	34 (100)	< 0.001	< 0.001	< 0.001	< 0.001
NFS score	-2.41 ± 1.71	-3.76 ± 1.19	-2.59 ± 1.59	-2.00 ± 1.69	-1.39 ± 1.60	0.002	0.033	< 0.001	0.043
Fib-4 score	0.88 ± 0.67	0.75 ± 0.47	0.79 ± 0.45	0.94 ± 0.86	1.11 ± 0.66	0.041	0.771	0.009	0.031
DBP	85.22 ± 12.07	82.26 ± 11	85.32 ± 13.22	86.34 ± 11.59	84.91 ± 11.80	0.631	0.333	0.643	0.958
SBP	133.86 ± 19.18	129.34 ± 16	133.00 ± 17.73	134.83 ± 20.8	139.56 ± 20.55	0.133	0.148	0.071	0.376
Platelet count	295.77 ± 90.85	305.91 ± 73	293.20 ± 91.20	294.06 ± 92.0	295.97 ± 110.13	0.888	0.644	0.856	0.811
Total cholesterol	183.29 ± 45.18	184.3 ± 47.11	181.03 ± 42.35	182.94 ± 48.3	190.41 ± 39.58	0.375	0.705	0.266	0.161
LDL	124.81 ± 39.85	120.58 ± 38.16	123.85 ± 39.87	126.52 ± 41.3	127.44 ± 37.20	0.859	0.949	0.648	0.573
HDL	38.55 ± 12.08	43.01 ± 11.93	41.65 ± 15.08	36.05 ± 8.93	32.38 ± 6.62	< 0.001	< 0.001	< 0.001	0.038
TG	184.79 ± 101.2	125.57 ± 51.8	182.45 ± 109.5	198.13 ± 98.8	221.85 ± 102.38	0.002	0.022	0.001	0.050
Total bilirubin	0.54 ± 0.37	0.55 ± 0.26	0.53 ± 0.35	0.57 ± 0.43	0.49 ± 0.31	0.284	0.358	0.287	0.157
Direct bilirubin	0.21 ± 0.24	0.21 ± 0.23	0.19 ± 0.09	0.24 ± 0.35	0.18 ± 0.08	0.601	0.417	0.732	0.417
Serum albumin	4.41 ± 0.38	4.51 ± 0.34	4.41 ± 0.37	4.37 ± 0.38	4.40 ± 0.43	0.552	0.305	0.481	0.906
ALT	40.67 ± 31.69	42.2 ± 29	37.03 ± 28.70	42.30 ± 36.49	44.09 ± 24.15	0.058	0.229	0.022	0.097
AST	31.84 ± 22.6	32.22 ± 20	28.62 ± 20.74	32.29 ± 23.36	40.06 ± 26.74	0.021	0.361	0.004	0.040
GGT	46.02 ± 34.77	42.45 ± 43.65	34.93 ± 21.08	51.50 ± 36.44	65.41 ± 38.02	< 0.001	< 0.001	< 0.001	0.016
ALP	110.82 ± 51.76	105.3 ± 40	111.90 ± 59.42	108.22 ± 46.1	125.24 ± 58.81	0.169	0.802	0.089	0.070
HbA1c	6.44 ± 1.65	5.32 ± 0.4	5.97 ± 1.13	6.82 ± 1.86	8.22 ± 1.58	< 0.001	< 0.001	< 0.001	< 0.001

MAFLD: Metabolic associated fatty liver disease; BMI: Body mass index; NFS: Nonalcoholic fatty liver disease fibrosis score; Fib-4: Fibrosis-4 index; DBP: Diastolic blood pressure; SBP: Systolic blood pressure; LDL: Low-density lipoprotein; HDL: High-density lipoprotein; TG: Triglyceride; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: γ-glutamyl transferase; ALP: Alkaline phosphatase; HbA1c: Glycated hemoglobin.

Table 2 Comparison of demographic, clinical, and laboratory characteristics among metabolic associated fatty liver disease with a single metabolic condition alone

Characteristic	Obesity alone (n = 61)	Lean MD (n = 34)	DM alone (n = 15)	P value
				Overall	Obesity vs lean MD	Obesity vs DM	Lean MD vs DM
Age (yr)	41.72 ± 10.03	45.53 ± 10.60	50.73 ± 9.04	0.005	0.082	0.002	0.116
BMI (kg/m2)	32.33 ± 4.66	24.86 ± 1.63	24.81 ± 1.58	< 0.001	< 0.001	< 0.001	0.965
Female Gender (%)	51 (83.6)	23 (67.6)	11 (73.3)	0.191	0.072	0.358	0.691
Hypertension (%)	8 (13.1)	6 (17.6)	0 (0.0)	0.230	0.551	0.138	0.082
NFS score	-2.86 ± 1.74	-2.50 ± 1.40	-1.61 ± 0.81	0.017	0.309	0.005	0.054
Fib-4 score	0.68 ± 0.35	0.92 ± 0.56	0.95 ± 0.48	0.027	0.050	0.017	0.761
DBP	84.26 ± 15.41	87.03 ± 10.43	85.73 ± 8.61	0.499	0.262	0.548	0.728
SBP	131.03 ± 17.46	135.82 ± 19.94	134.60 ± 12.89	0.306	0.255	0.181	0.828
Platelet count	314.85 ± 97.95	275.44 ± 81.92	245.40 ± 50.70	0.004	0.032	0.002	0.298
Total cholesterol	176.91 ± 37.71	190.97 ± 49.33	175.00 ± 41.93	0.336	0.160	0.879	0.313
LDL	120.53 ± 35.87	126.76 ± 44.83	130.73 ± 44.80	0.626	0.473	0.433	0.688
HDL	42.50 ± 11.14	39.96 ± 21.71	42.30 ± 8.73	0.026	0.010	0.678	0.079
TG	135.75 ± 57.72	269.02 ± 120.03	176.13 ± 132.33	< 0.001	< 0.001	0.213	0.001
Total bilirubin	0.52 ± 0.43	0.55 ± 0.24	0.50 ± 0.22	0.171	0.055	0.698	0.467
Direct bilirubin	0.19 ± 0.10	0.18 ± 0.08	0.20 ± 0.09	0.613	0.480	0.549	0.424
Serum albumin	4.41 ± 0.34	4.40 ± 0.33	4.44 ± 0.59	0.731	0.779	0.526	0.428
ALT	33.89 ± 30.47	43.94 ± 28.41	34.13 ± 19.04	0.043	0.016	0.264	0.288
AST	25.75 ± 15.38	34.76 ± 29.26	26.33 ± 13.60	0.086	0.025	0.724	0.302
GGT	32.32 ± 21.22	37.85 ± 20.37	39.15 ± 22.28	0.139	0.083	0.169	0.849
ALP	113.61 ± 68.86	107.03 ± 39.59	116.00 ± 58.23	0.948	0.880	0.734	0.888
HbA1c	5.56 ± 0.46	5.77 ± 0.48	8.03 ± 1.71	< 0.001	0.006	< 0.001	< 0.001

MD: Metabolic dysfunction; DM: Diabetes mellitus; BMI: Body mass index; NFS: Nonalcoholic fatty liver disease fibrosis score; Fib-4: Fibrosis-4 index; DBP: Diastolic blood pressure; SBP: Systolic blood pressure; LDL: Low-density lipoprotein; HDL: High-density lipoprotein; TG: Triglyceride; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: γ-glutamyl transferase; ALP: Alkaline phosphatase; HbA1c: Glycated hemoglobin.