Pham TTT, Ho DT, Pham C, Phan H, Phu B, Nguyen T, Nguyen D, Phan HT, Nguyen KM. Role of mac-2 binding protein glycosylation isomer in predicting fibrosis in patients with metabolic dysfunction-associated steatotic liver disease. World J Hepatol 2025; 17(7): 106991 [DOI: 10.4254/wjh.v17.i7.106991]
Corresponding Author of This Article
Khue Minh Nguyen, Senior Scientist, Department of Genetics, Ho Chi Minh University of Science, 227 Nguyen Van Cu, District 5, Ho Chi Minh 700000, Viet Nam. minhkhuenguyen8888@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jul 27, 2025; 17(7): 106991 Published online Jul 27, 2025. doi: 10.4254/wjh.v17.i7.106991
Role of mac-2 binding protein glycosylation isomer in predicting fibrosis in patients with metabolic dysfunction-associated steatotic liver disease
Thuy Thi Thu Pham, Dat Tan Ho, Chanh Pham, Hoan Phan, Bieu Phu, Toan Nguyen, Dang Nguyen, Hai Thanh Phan, Khue Minh Nguyen
Thuy Thi Thu Pham, Dat Tan Ho, Chanh Pham, Hoan Phan, Bieu Phu, Department of Hepatology, Medic Medical Center, Ho Chi Minh 72517, Viet Nam
Toan Nguyen, Department of Laboratory, Medic Medical Center, Ho Chi Minh 84, Viet Nam
Dang Nguyen, Hai Thanh Phan, Department of Imaging Diagnostic, Medic Medical Center, Ho Chi Minh 84, Viet Nam
Khue Minh Nguyen, Department of Genetics, Ho Chi Minh University of Science, Ho Chi Minh 700000, Viet Nam
Khue Minh Nguyen, Department of Scientific Affairs, Sysmex Vietnam, Ho Chi Minh 700000, Viet Nam
Author contributions: Pham TTT, Ho DT, Pham C, Phan H and Phu B conducted the patients’ recruitment; Pham TTT, Ho DT and Nguyen KM contributed equally in their efforts towards completion of the study, performed the conceptualization, design of the study, the materials’ preparation, and data acquisition and analysis; Nguyen T managed the laboratory tests’ performance and provided overall logistical administration of the study; Nguyen D and Phan HT managed the FibroScan performance and provided ultimate supervision of the study; Nguyen KM developed the original draft of the manuscript; all authors contributed to writing of the sequential revisions of the manuscript and approved the final version.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Medic Medical Center.
Clinical trial registration statement: Not applicable.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Khue Minh Nguyen is a Sysmex employee. All other authors declare no conflicts of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at minhkhuenguyen8888@gmail.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Khue Minh Nguyen, Senior Scientist, Department of Genetics, Ho Chi Minh University of Science, 227 Nguyen Van Cu, District 5, Ho Chi Minh 700000, Viet Nam. minhkhuenguyen8888@gmail.com
Received: March 13, 2025 Revised: April 30, 2025 Accepted: June 13, 2025 Published online: July 27, 2025 Processing time: 134 Days and 23.1 Hours
Abstract
BACKGROUND
Mac-2 binding protein glycosylation isomer (M2BPGi) serves as a marker of activated hepatic stellate cells and as such holds potential as a biomarker for liver fibrosis. In Viet Nam, metabolic dysfunction-associated steatotic liver disease (MASLD) is rising in prevalence and there is an urgent need for better clinical management, particularly in early detection methods that will improve overall prognosis.
AIM
To examine M2BPGi cut-off values for staging liver fibrosis in patients with MASLD and risk factors associated with disease progression.
METHODS
A total of 301 individuals with ultrasound-confirmed or FibroScan-confirmed diagnosis of fatty liver were enrolled in the study. The participants were stratified according to fibrosis stage, measured via magnetic resonance elastography. M2BPGi, Fibrosis-4 (FIB-4) Index score, and routine parameters of liver function were assessed to statistically investigate the correlation of M2BPGi levels in various fibrosis stages and to identify risk factors associated with fibrosis severity.
RESULTS
M2BPGi levels positively correlated with fibrosis stages, with cut-off indexes of 0.57 for F0-1, 0.68 for F2-3, and 0.78 for F4. M2BPGi levels in the F0-1 group were significantly different from those in both the F2-3 group (P = 0.038) and the F4 group (P = 0.0051); the F2-3 and F4 groups did not show a significant difference (P = 0.39). Females exhibited significantly higher M2BPGi levels than males for all fibrosis stages, particularly in the F2-3 group (P = 0.01) and F4 group (P = 0.0006). In the F4 (cirrhosis) group, individuals with diabetes had significantly higher M2BPGi levels than those without. M2BPGi, hemoglobin A1c, and FIB-4 score were identified as independent risk factors for greater fibrosis and cirrhosis.
CONCLUSION
M2BPGi levels varied significantly throughout fibrosis progression, from early MASLD to cirrhosis, with sex correlation. M2BPGi holds promise as an early biomarker for fibrosis characterization in MASLD adult patient populations.
Core Tip: This study investigated the role of mac-2 binding protein glycosylation isomer (M2BPGi) as a novel biomarker for staging liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease in Viet Nam. It established the optimal cut-off values for M2BPGi across fibrosis stages (F0-F4), revealing a moderate correlation with FibroScan and magnetic resonance elastography findings. Ultimately, M2BPGi, Fibrosis-4 Index score, and hemoglobin A1c were identified as independent risk factors for greater fibrosis and cirrhosis (F4), emphasizing M2BPGi's potential in early detection and risk stratification.
