Predictive value of angiopoietin-like protein 8 in metabolic dysfunction-associated fatty liver disease and its progression: A case-control study

Table 1 Clinical characteristics of all study subjects

	Non-MAFLD group (n = 80)	MAFLD group (n = 80)	P valuea
Sex (female/male)	37/43	33/47	0.5241
Age (yr)	55.35 ± 12.77	54.70 ± 12.15	0.7452
WHR	0.89 ± 0.09	0.92 ± 0.07	0.0392
BMI (kg/m2)	22.06 (20.16, 24.64)	24.41 (22.89, 27.61)	< 0.0013
SBP (mmHg)	131.00 (121.75, 147.25)	136.00 (125.00, 150.00)	0.1933
DBP (mmHg)	83.50 (75.75, 94.00)	87.00 (79.00, 92.00)	0.2373
MAP (mmHg)	100.00 (91.00, 112.25)	104.00 (95.00, 111.00)	0.1513
ALT (U/L)	14.00 (10.00, 22.75)	18.00 (12.00, 25.75)	0.0143
AST (U/L)	18.00 (15.75, 22.00)	19.50 (15.00, 24.00)	0.1813
TC (mmol/L)	4.29 (3.55, 4.96)	4.39 (3.61, 5.54)	0.2223
TG (mmol/L)	1.04 (0.62, 1.54)	2.69 (1.39, 4.35)	< 0.0013
HDL-C (mmol/L)	1.31 (1.04, 1.60)	1.17 (0.85, 1.41)	0.0153
LDL-C (mmol/L)	2.28 ± 0.99	2.51 ± 1.05	0.1442
TG/HDL-C	0.84 (0.46, 1.33)	2.73 (1.14, 4.24)	< 0.0013
LDL-C/HDL-C	1.71 (1.26, 2.29)	2.06 (1.59, 2.92)	0.0053
HbA1c (%)	6.00 (5.44, 8.70)	7.00 (6.13, 8.58)	0.0183
FPG (mmol/L)	6.58 (5.63, 8.68)	6.67 (5.93, 9.28)	0.3703
FINS (μU∕mL)	7.01 (4.98, 9.72)	10.00 (5.97, 13.66)	0.0043
HOMA-β (%)	50.10 (23.25, 87.63)	55.29 (33.96, 94.46)	0.1563
HOMA-IR	2.08 (1.40, 3.34)	2.99 (1.73, 5.50)	0.0083
CRP (mg/L)	1.57 (0.98, 2.21)	1.74 (1.19, 2.90)	0.0203
ANGPTL8 (pg/mL)	23.95 (16.52, 34.20)	44.93 (33.41, 58.01)	< 0.0013
FIB-4 index	1.18 (0.96, 1.46)	1.39 (1.23, 1.76)	< 0.0013
TyG index	8.66 ± 0.71	9.56 ± 0.92	< 0.0012

^aP < 0.05 is considered significant.

¹χ² test.

²t-test.

³Mann Whitney U test.

MAFLD: Metabolic dysfunction-associated fatty liver disease; WHR: Waist-to-hip ratio; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; MAP: Mean arterial pressure; ALT: Alanine transaminase; AST: Aspartate transaminase; TG: Triglyceride; TC: Total cholesterol; HDL-C: High-density lipoprotein-cholesterol; LDL-C: Low-density lipoprotein-cholesterol; HbA1c: Glycated hemoglobin; FPG: Fasting plasma glucose; FINS: Fasting insulin; HOMA-β: Homeostasis model assessment of β-cell function; HOMA-IR: Homeostasis model assessment of insulin resistance; CRP: C-reactive protein; ANGPTL8: Angiopoietin-like protein 8; FIB-4 index: Fibrosis-4 index; TyG index: Triglyceride-glucose index.

Table 2 Spearman correlation analysis of metabolic dysfunction-associated fatty liver disease and various indicators

	r	P valuea
ANGPTL8	0.576	< 0.001
TyG index	0.473	< 0.001
FIB-4 index	0.318	< 0.001
BMI	0.394	< 0.001
WHR	0.172	0.031
TG	0.581	< 0.001
HDL-C	-0.195	0.014
ALT	0.195	0.014
FINS	0.231	0.003
HbA1c	0.189	0.017
HOMA-IR	0.211	0.008
CRP	0.189	0.018
TG/HDL-C	0.551	< 0.001
LDL-C/HDL-C	0.226	0.004

^aP < 0.05 is considered significant.

ANGPTL8: Angiopoietin-like protein 8; TyG index: Triglyceride-glucose index; FIB-4 index: Fibrosis-4 index; BMI: Body mass index; WHR: Waist-to-hip ratio; TG: Triglyceride; HDL-C: High-density lipoprotein-cholesterol; ALT: Alanine transaminase; FINS: Fasting insulin; HbA1c: Glycated hemoglobin; HOMA-IR: Homeostasis model assessment of insulin resistance; CRP: C-reactive protein; LDL-C: Low-density lipoprotein-cholesterol.

Table 3 Multifactor logistic regression analysis of factors influencing metabolic dysfunction-associated fatty liver disease

	B	S.E.	Wals	P valuea	EXP(B)	95%CI
ANGPTL8	0.116	0.027	19.118	< 0.001	1.123	1.066-1.184
BMI	0.275	0.111	6.142	0.013	1.317	1.059-1.637
ALT	0.032	0.021	2.394	0.122	1.032	0.992-1.075
HDL-C	-0.386	0.804	0.231	0.631	0.680	0.141-3.287
FINS	0.085	0.091	0.875	0.350	1.088	0.911-1.300
HbA1c	-0.248	0.176	1.982	0.159	0.780	0.552-1.102
HOMA-IR	-0.426	0.251	2.869	0.090	0.653	0.399-1.069
CRP	0.160	0.088	3.285	0.070	1.173	0.987-1.395
WHR	-3.793	4.066	0.870	0.351	0.023	0.000-65.098
TG	2.255	0.527	18.277	< 0.001	9.532	3.391-26.800

^aP < 0.05 is considered significant.

CI: Confidence interval; ANGPTL8: Angiopoietin-like protein 8; BMI: Body mass index; ALT: Alanine transaminase; HDL-C: High-density lipoprotein-cholesterol; FINS: Fasting insulin; HbA1c: Glycated hemoglobin; HOMA-IR: Homeostasis model assessment of insulin resistance; CRP: C-reactive protein; WHR: Waist-to-hip ratio; TG: Triglyceride.

Table 4 Spearman correlation of metabolic dysfunction-associated fatty liver disease complicated with liver fibrosis with serum angiopoietin-like protein 8, C-reactive protein, and triglyceride-glucose index

	r	P valuea
ANGPTL8	0.489	< 0.001
TyG index	0.294	0.008
CRP	-0.238	0.033

^aP < 0.05 is considered significant.

ANGPTL8: Angiopoietin-like protein 8; CRP: C-reactive protein; TyG index: Triglyceride-glucose index.

Table 5 Logistical analysis of metabolic dysfunction-associated fatty liver disease with liver fibrosis

	B	S.E.	Wals	P valuea	EXP(B)	95%CI
ANGPTL8	0.089	0.023	14.513	< 0.001	1.093	1.044-1.144
TyG index	0868	0.350	6.146	0.013	2.383	1.199-4.736
CRP	-0.560	0.302	3.449	0.063	0.571	0.316-1.032

^aP < 0.05 is considered significant.

CI: Confidence interval; ANGPTL8: Angiopoietin-like protein 8; TyG index: Triglyceride-glucose index; CRP: C-reactive protein.

Table 6 Receiver operating characteristic curve analysis of the predictive value of angiopoietin-like protein 8, triglyceride-glucose index, and its combination with triglyceride-glucose index for metabolic dysfunction-associated fatty liver disease and liver fibrosis

	AUC	95%CI	Cutoff	Sensitivity	Specificity	P valuea
Prediction of MAFLD
ANGPTL8	0.832	0.771-0.893	31.18	80.00	73.08	< 0.001
TyG index	0.773	0.701-0.845	9.155	67.5	80.77	< 0.001
ANGPTL8 + TyG index	0.886	0.846-0.941	0.546	75.5	85.9	< 0.001
Prediction of MAFLD with liver fibrosis
ANGPTL8	0.812	0.713-0.910	44.36	91.30	61.36	< 0.001
TyG index	0.688	0.553-0.822	9.925	60.87	75.44	< 0.001
ANGPTL8 + TyG index	0.835	0.735-0.935	0.3897	73.91	78.95	< 0.001

^aP < 0.05 is considered significant.

AUC: Area under the curve; MAFLD: Metabolic dysfunction-associated fatty liver disease; CI: Confidence interval; ANGPTL8: Angiopoietin-like protein 8; TyG index: Triglyceride-glucose index.