Role of hepatic sonic hedgehog protein expression in the diagnosis of metabolic dysfunction-associated steatohepatitis

doi:10.3748/wjg.v32.i12.113939

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Mar 28, 2026 (publication date) through Mar 19, 2026

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World Journal of Gastroenterology

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1007-9327

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Retrospective Cohort Study

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. Mar 28, 2026; 32(12): 113939
Published online Mar 28, 2026. doi: 10.3748/wjg.v32.i12.113939

Table 1 Comparison of clinical parameters in metabolic dysfunction-associated steatotic liver and metabolic dysfunction-associated steatohepatitis patients, n (%)

	MASL (n = 78)	MASH (n = 112)	P value
Sex (male)	48 (61.54)	57 (50.89)	0.147
Age (year)	45.54 ± 12.93	43.77 ± 15.34	0.391
BMI (kg/m², median)	23.31 (22.2, 25.9)	25.75 (23.9, 27.9)	0.000
Hypertension	16 (20.51)	34 (30.36)	0.130
Diabetes	5 (6.14)	24 (21.43)	0.005
Metabolic syndrome	17 (21.52)	43 (38.74)	0.011
ALT (U/L, median)	49.60 (29.6, 87.1)	98.60 (69.2, 163.1)	0.000
AST (U/L, median)	28.750 (20.5, 40.1)	56.550 (39.8, 81.0)	0.000
GGT (U/L, median)	86.950 (28.9, 207.1)	80.75 (45.2, 127.0)	0.520
ALP (U/L, median)	91.70 (73.0, 117.0)	86.30 (71.6, 105.0)	0.261
ALB	43.90 (41.5, 47.1)	45.050 (42.5, 47.0)	0.341
TBIL	13.450 (9.6, 18.3)	13.300 (9.6, 17.1)	0.610
BUN	4.700 (4.1, 5.8)	4.460 (3.8, 5.5)	0.143
Cr	68.0 (58.0, 81.5)	65.50 (52.8, 77.0)	0.132
UA	348.0 (272.8, 402.0)	364.50 (299.5, 449.0)	0.028
TG	1.710 (1.1, 2.3)	1.570 (1.3, 2.2)	0.823
TC	4.50 (3.9, 5.2)	4.760 (4.3, 5.5)	0.078
LDL	2.89 ± 0.78	3.10 ± 0.82	0.092
HDL	1.11 ± 0.26	1.09 ± 0.21	0.602
GLU	5.240 (4.7, 5.6)	5.425 (4.9, 6.1)	0.011
M30	153.0 (153.0, 228.6)	476.0 (391.1, 549.0)	0.000
M65	168.0 (153.3, 282.0)	579.0 (537.1, 621.3)	0.000
CAP	250.0 (228.5, 261.0)	291.0 (276.5, 313.0)	0.000
LSM	5.050 (4.1, 6.7)	7.40 (4.7, 10.2)	0.003
NFS	2.283 (1.8, 2.6)	2.626 (2.0, 3.2)	0.006

P < 0.05 indicates statistically significant difference. Nonalcoholic fatty liver disease fibrosis score = -1.675 + 0.037 × age + 0.094 × body mass index (kg/m²) + 1.13 × [impaired fasting glucose or diabetes (yes = 1, no = 0)] + 0.99 × aspartate aminotransferase/alanine aminotransferase - 0.013 × platelet (× 10⁹/L) - 0.66 × albumin (g/dL). MASL: Metabolic dysfunction-associated steatotic liver; MASH: Metabolic dysfunction-associated steatohepatitis; BMI: Body mass index; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: Gamma-glutamyl transferase; ALP: Alkaline phosphatase; ALB: Albumin; TBIL: Total bilirubin; BUN: Blood urea nitrogen; Cr: Creatinine; UA: Uric acid; TG: Triglyceride; TC: Total cholesterol; LDL: Low-density lipoprotein; HDL: High-density lipoprotein; GLU: Glucose; CAP: Controlled attenuation parameter; LSM: Liver stiffness measurement; NFS: Nonalcoholic fatty liver disease fibrosis score.

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Table 2 Comparison of pathological parameters in metabolic dysfunction-associated steatotic liver and metabolic dysfunction-associated steatohepatitis patients, n (%)

	MASL (n = 78)	MASH (n = 112)	P value
Steatosis			0.000
Score 1	71 (91.03)	21 (18.75)
Score 2	6 (7.69)	50 (44.64)
Score 3	1 (1.28)	41 (36.61)
Ballooned hepatocytes with H&E staining and SHH + CK8/18 immunostaining			0.000
Score 0	37 (47.44)	0
Score 1	41 (52.56)	49 (43.75)
Score 2	0	63 (56.25)
Lobular inflammation			0.000
Score 0	2 (2.56)	0
Score 1	56 (71.79)	4 (3.57)
Score 2	19 (24.36)	48 (42.86)
Score 3	1 (1.28)	60 (53.57)
Fibrosis			0.000
Score 0	39 (50.0)	11 (9.82)
Score 1	30 (38.46)	31 (27.68)
Score 2	8 (10.26)	32 (28.57)
Score 3	1 (1.28)	30 (26.79)
Score 4	0	8 (7.14)

P < 0.05 indicates statistically significant difference. MASL: Metabolic dysfunction-associated steatotic liver; MASH: Metabolic dysfunction-associated steatohepatitis; H&E: Hematoxylin and eosin; SHH: Sonic hedgehog; CK8/18: Cytokeratin 8/18.

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Table 3 Binary logistic regression analysis of risk factors associated with metabolic dysfunction-associated steatohepatitis

	B	SE	Wald	df	Sig	Exp(B)	95%CI for Exp(B)
Diabetes	3.042	1.504	4.094	1	0.043	20.95	1.100-399.132
AST	0.043	0.019	5.176	1	0.023	1.044	1.006-1.083
CAP	0.033	0.013	6.991	1	0.008	1.034	1.009-1.059
SHH	1.967	0.822	5.722	1	0.017	7.151	1.427-35.848
Constant	-13.551	3.737	13.149	1	0.000	0.001	-

AST: Aspartate aminotransferase; CAP: Controlled attenuation parameter; SHH: Sonic hedgehog; CI: Confidence interval.

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Table 4 Binary logistic regression analysis of risk factors associated with advanced fibrosis

	B	SE	Wald	df	Sig	Exp(B)	95%CI for Exp(B)
Ballooned hepatocytes	1.863	0.820	5.161	1	0.023	6.440	1.291-32.114
M30	0.012	0.004	7.871	1	0.005	1.012	1.004-1.021
Constant	2.657	3.721	0.510	1	0.000	14.247	-

CI: Confidence interval.

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Citation: Han X, Chen MY, Xiong QF, Zhong YD, Liu DX, Li J, Yang YF. Role of hepatic sonic hedgehog protein expression in the diagnosis of metabolic dysfunction-associated steatohepatitis. World J Gastroenterol 2026; 32(12): 113939
URL: https://www.wjgnet.com/1007-9327/full/v32/i12/113939.htm
DOI: https://dx.doi.org/10.3748/wjg.v32.i12.113939