Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 15, 2024; 15(3): 418-428
Published online Mar 15, 2024. doi: 10.4239/wjd.v15.i3.418
Predictive value of angiopoietin-like protein 8 in metabolic dysfunction-associated fatty liver disease and its progression: A case-control study
Lu-Lu Gan, Can Xia, Xuan Zhu, Yue Gao, Wen-Chang Wu, Qi Li, Ling Li, Zhe Dai, Yi-Min Yan
Lu-Lu Gan, Can Xia, Xuan Zhu, Yue Gao, Wen-Chang Wu, Yi-Min Yan, Medical College, Wuhan University of Science and Technology, Wuhan 430071, Hubei Province, China
Lu-Lu Gan, Qi Li, Ling Li, Yi-Min Yan, Department of Endocrinology, Xiaogan Hospital Affiliated with Wuhan University of Science and Technology, The Central Hospital of Xiaogan, Xiaogan 432000, Hubei Province, China
Zhe Dai, Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
Author contributions: Gan LL participated in the study design and wrote the manuscript; Yan YM conducted the design of the study and reviewed/edited the drafts, and is guarantor; Gan LL, Zhu X, Xia C, Gao Y and Wu WC collected and analyzed the data; Li Q, Li L and Dai Z revised the manuscript. All authors contributed to the article and approved the submitted article.
Supported by Youth Talents Project of Joint Fund of Hubei Health Commission, No. WJ2019H170; and Xiaogan Natural Science Project, No. XGKJ2020010033.
Institutional review board statement: The study protocol was approved by the ethics committee of Xiaogan Central Hospital (Approval No. XGLY2021-08-01).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
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: Yi-Min Yan, MD, Deputy Director, Department of Endocrinology, Xiaogan Hospital Affiliated with Wuhan University of Science and Technology, The Central Hospital of Xiaogan, No. 6 Plaza Street, Xiaogan 432000, Hubei Province, China. yanyimin180@163.com
Received: October 28, 2023
Peer-review started: October 28, 2023
First decision: December 23, 2023
Revised: January 5, 2024
Accepted: February 18, 2024
Article in press: February 18, 2024
Published online: March 15, 2024
Processing time: 138 Days and 17.3 Hours
Abstract
BACKGROUND

The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) is rapidly increasing, currently affecting approximately 25% of the global population. Liver fibrosis represents a crucial stage in the development of MAFLD, with advanced liver fibrosis elevating the risks of cirrhosis and hepatocellular carcinoma. Simple serum markers are less effective in diagnosing liver fibrosis compared to more complex markers. However, imaging techniques like transient elastography face limitations in clinical application due to equipment and technical constraints. Consequently, it is imperative to identify a straightforward yet effective method for assessing MAFLD-associated liver fibrosis.

AIM

To investigate the predictive value of angiopoietin-like protein 8 (ANGPTL8) in MAFLD and its progression.

METHODS

We analyzed 160 patients who underwent abdominal ultrasonography in the Endocrinology Department, Xiaogan Central Hospital affiliated to Wuhan University of Science and Technology, during September 2021-July 2022. Using abdominal ultrasonography and MAFLD diagnostic criteria, among the 160 patients, 80 patients (50%) were diagnosed with MAFLD. The MAFLD group was divided into the liver fibrosis group (n = 23) and non-liver fibrosis group (n = 57) by using a cut-off fibrosis-4 index ≥ 1.45. Logistical regression was used to analyze the risk of MAFLD and the risk factors for its progression. Receiver operating characteristic curves were used to evaluate the predictive value of serum ANGPTL8 in MAFLD and its progression.

RESULTS

Compared with non-MAFLD patients, MAFLD patients had higher serum ANGPTL8 and triglyceride-glucose (TyG) index (both P < 0.05). Serum ANGPTL8 (r = 0.576, P < 0.001) and TyG index (r = 0.473, P < 0.001) were positively correlated with MAFLD. Serum ANGPTL8 was a risk factor for MAFLD [odds ratio (OR): 1.123, 95% confidence interval (CI): 1.066-1.184, P < 0.001). Serum ANGPTL8 and ANGPTL8 + TyG index predicted MAFLD [area under the curve (AUC): 0.832 and 0.886, respectively; both P < 0.05]. Compared with MAFLD patients without fibrosis, those with fibrosis had higher serum ANGPTL8 and TyG index (both P < 0.05), and both parameters were positively correlated with MAFLD-associated fibrosis. Elevated serum ANGPTL8 (OR: 1.093, 95%CI: 1.044-1.144, P < 0.001) and TyG index (OR: 2.383, 95%CI: 1.199-4.736, P < 0.013) were risk factors for MAFLD-associated fibrosis. Serum ANGPTL8 and ANGPTL8 + TyG index predicted MAFLD-associated fibrosis (AUC: 0.812 and 0.835, respectively; both P < 0.05).

CONCLUSION

The serum levels of ANGPTL8 are elevated and positively correlated with MAFLD. They can serve as predictors for the risk of MAFLD and liver fibrosis, with the ANGPTL8 + TyG index potentially exhibiting even higher predictive value.

Keywords: Angiopoietin-like protein 8; Metabolic dysfunction-associated fatty liver disease; Fibrosis-4 index; Liver fibrosis

Core Tip: This study unveils elevated serum levels of angiopoietin-like protein 8 (ANGPTL8) in individuals with metabolic dysfunction-associated fatty liver disease (MAFLD). Serum ANGPTL8 emerges not only as a predictive factor for MAFLD risk but also as a powerful indicator for the presence of liver fibrosis in MAFLD. The amalgamation of serum ANGPTL8 with the triglyceride-glucose index demonstrates potential for heightened predictive accuracy in both conditions. Further exploration of serum ANGPTL8 holds promise for enhancing clinical strategies in the prevention and treatment of MAFLD.