Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Jul 28, 2026; 32(28): 117181
Published online Jul 28, 2026. doi: 10.3748/wjg.117181
Published online Jul 28, 2026. doi: 10.3748/wjg.117181
Do biomarkers matter? Cardiovascular risk stratification in Asian patients with metabolic dysfunction-associated steatotic liver disease in the era of fibrosis-centric assessment
Manjeet Kumar Goyal, Department of Internal Medicine, Cleveland Clinic Akron General Hospital, Akron, OH 44308, United States
Juniali Hatwal, Department of Internal Medicine, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Rupak Desai, Outcomes Research, Independent Researcher, Atlanta, GA 30033, United States
Tanisha Sehgal, Department of Medicine, Dayanand Medical College and Hospital, Ludhiana 141001, India
Akash Batta, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Author contributions: Goyal MK and Batta A designed the review; Goyal MK performed the literature review and data collection; Hatwal J, Sehgal T, and Desai R supervised the manuscript and provided key feedback and suggestions; Goyal MK and Batta A wrote the manuscript and subsequently revised it. All authors have read and approved the final manuscript.
AI contribution statement: The AI tool Grammarly was used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Akash Batta, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana 141001, Punjab, India.
Received: December 1, 2025
Revised: February 1, 2026
Accepted: March 5, 2026
Published online: July 28, 2026
Processing time: 220 Days and 19.4 Hours
Revised: February 1, 2026
Accepted: March 5, 2026
Published online: July 28, 2026
Processing time: 220 Days and 19.4 Hours
Core Tip
Core Tip: Cardiovascular risk in Asian patients with metabolic dysfunction-associated steatotic liver disease is multifactorial and not adequately captured by single biomarkers. While metabolic indices reflect upstream metabolic stress, their prognostic value for cardiovascular events remains limited. Inflammatory markers are mechanistically relevant but confounded by their inclusion in disease definitions. In contrast, fibrosis-based scores, consistently associate with cardiovascular outcomes across Asian cohorts, likely reflecting cumulative metabolic injury. An integrated, multivariable approach combining metabolic, inflammatory, and fibrosis markers is more appropriate for cardiovascular risk stratification in this population.