Role of mac-2 binding protein glycosylation isomer in predicting fibrosis in patients with metabolic dysfunction-associated steatotic liver disease

Table 1 Baseline characteristics of the total 301 study participants, n (%)

Variables	Median (interquartile range)1
Sex
Male	177 (58.8)
Female	124 (41.2)
Age (years)	52 (42-59)
Body mass index (kg/m2)	26.4 (24.5-28.4)
Aspartate aminotransferase (U/L)	30 (22-43)
Alanine aminotransferase (U/L)	40 (25-70.5)
Low density lipoprotein-cholesterol (mmol/L)	3.2 (2.5-4.2)
Triglycerides (mmol/L)	2.3 (1.7-3.5)
Total cholesterol (mmol/L)	5.4 (4.6-6.2)
Gamma glutamyl transferase (U/L)	68 (37.5-120.5)
White blood cell (109/L)	8 (6.9-9.4)
Hemoglobin (g/L)	14.6 (13.5-15.7)
Platelet count (109/L)	261 (224.5-300.5)
Hemoglobin A1c (National Glycohemoglobin Standardization Program)	5.9 (5.6-6.7)
Glucose (mmol/L)	6.2 (5.6-7.5)
Fasting plasma glucose (mg/Dl)	111.9 (101.4-134.3)
Estimated glomerular filtration rate (mL/min/1.73 m2)	100 (89-108)
FibroScan (kPa)	7.7 (6.2-9.4)
Mac-2 binding protein glycosylation isomer level (cut-off index)	0.67 (0.5-0.9)
Aspartate aminotransferase-to-platelet ratio index	0.3 (0.2-0.4)
Fibrosis-4 Index	0.9 (0.6-1.3)
Controlled attenuation parameter	301 (274-327.5)
Fibrosis stage
F0-1	90 (29.9)
F2-3	168 (55.8)
F4	43 (14.3)
Comorbidity
Obesity	41 (13.6)
Diabetes	83 (27.6)

¹Unless otherwise indicated.

Table 2 Variables according to fibrosis stages stratified by magnetic resonance elastography, n (%)

Variables	No or mild fibrosis (group 1) [Median (IQR)]	Significant fibrosis (group 2) [Median (IQR)]	Cirrhosis (group 3) [Median (IQR)]	P value1
				Group 1 vs group 2	Group 2 vs group 3	Group 1 vs group 3	All
Age (years)	49 (40.75-56.00)	53 (42-61.75)	52 (43-62)	0.0604	0.9999	0.2393	0.06
Sex
Male	55 (61.1)	94 (57)	29 (67.4)	ND	ND	ND	ND
Female	35 (38.9)	71 (43)	14 (32.6)	ND	ND	ND	ND
Aspartate aminotransferase (U/L)	27 (21.84-36.25)	31 (22-45)	34.5 (25.25-53)	0.0724	0.0075	0.341	0.0062
Alanine aminotransferase (U/L)	31 (22.75-64.5)	45.5 (25-72.25)	47.5 (29-73.75)	0.1252	> 0.9999	0.2029	0.0741
Gamma glutamyl transferase (U/L)	58.5 (34-110.5)	70.5 (37.25-119)	84 (54-151)	0.6769	0.0987	0.0144	0.0187
Body mass index (kg/m2)	26.63 (24.4-28.9)	26.3 (24.4-28)	27 (24.8-31)	> 0.9999	0.1613	0.2832	0.1449
FibroScan (kPa)	6.3 (5.78-7.7)	8 (7.03-9.5)	11 (7.1-15.7)	< 0.0001	0.0018	< 0.0001	< 0.0001
Fibrosis-4 Index	0.76 (0.57-1.00)	0.95 (0.67-1.35)	1.18 (0.7-1.79)	0.0092	0.2237	0.0007	0.0004
Aspartate aminotransferase-to-platelet ratio index	0.26 (0.19-0.36)	0.32 (0.21-0.46)	0.33 (0.21-0.62)	0.023	> 0.9999	0.029	0.0073
Mac-2 binding protein glycosylation isomer (cut-off index)	0.57 (0.45-0.81)	0.68 (0.52-0.9)	0.78 (0.58-1.17)	0.038	0.39	0.005	0.0035
Hemoglobin A1c	5.78 (5.45-6.31)	6 (5.59-6.8)	5.92 (5.65-7.52)	0.0344	> 0.9999	0.1148	0.0241
Glucose (mmol/L)	5.85 (5.49-6.59)	6.42 (5.69-7.55)	6.42 (5.66-9.02)	0.0083	> 0.9999	0.0243	0.0041
Low density lipoprotein-cholesterol (mmol/L)	3.35 (2.61-4.19)	3.13 (2.45-4.1)	3.7 (2.62-4.59)	> 0.9999	0.2192	0.9231	0.1824
Triglycerides (mmol/L)	2.29 (1.62-3.22)	2.43 (1.75-3.68)	2.08 (1.73-3.28)	0.8688	> 0.9999	> 0.9999	0.4874
Total cholesterol (mmol/L)	5.3 (4.66-6.17)	5.24 (4.37-6.22)	5.57 (4.84-6.74)	> 0.9999	0.5871	> 0.9999	0.4242
Comorbidity
Hyperglycemia	20 (22.2)	71 (42.3)	22 (51.2)	ND	ND	ND	ND
Diabetes	15 (16.7)	52 (31)	16 (37.2)	ND	ND	ND	ND
Obesity	12 (13.3)	20 (11.9)	12 (27.9)	ND	ND	ND	ND

¹Dunn’s test was performed to compare individual groups in post-hoc analysis, P < 0.05.

ND: Not done; IQR: Interquartile range.

Table 3 Univariate and multivariate logistic regression identification of risk factors of significant fibrosis and cirrhosis, n (%)

Condition	Variable	Univariate analysis		Multivariate analysis
		OR	95%CI	Adjusted OR	95%CI
Significant fibrosis	Age	1.02	1-1.04	1	0.98-1.03
	Sex
	Male	Reference		Reference
	Female	1.15	0.69-1.91	0.72	0.4-1.3
	FIB-4	2.41	1.48-4.23	2.1	1.18-4.3
	M2BPGi (COI)	2.3	1.18-4.93	1.6	0.74-3.8
	HbA1c	1.43	1.13-1.86	1.4	1.08-1.81
Cirrhosis	Age	1	0.98-1.03	0.99	0.96-1.03
	Sex
	Male	1.5	0.79-3.13	2.5	1.1-5.78
	Female	Reference		Reference
	FIB-4	2.2	1.54-3.35	1.2	0.92-1.53
	M2BPGi (COI)	2.4	1.37-4.47	1.7	0.85-3.6
	HbA1c	1.2	0.95-1.45	1.2	0.92-1.53

COI: Cut-off index; FIB-4: Fibrosis-4 Index; HbA1c: Hemoglobin A1c; M2BPGi: Mac-2 binding protein glycosylation isomer; OR: Odds ratio.