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. 2025 Jan 7;37(1):59-68.e3.
doi: 10.1016/j.cmet.2024.10.008. Epub 2024 Nov 4.

A blood-based biomarker panel for non-invasive diagnosis of metabolic dysfunction-associated steatohepatitis

Xiang Zhang  1 , Ming-Hua Zheng  2 , Dehua Liu  1 , Yufeng Lin  1 , Sherlot Juan Song  1 , Eagle Siu-Hong Chu  1 , Dabin Liu  1 , Seema Singh  3 , Michael Berman  3 , Harry Cheuk-Hay Lau  1 , Hongyan Gou  1 , Grace Lai-Hung Wong  1 , Ni Zhang  2 , Hai-Yang Yuan  2 , Rohit Loomba  4 , Vincent Wai-Sun Wong  5 , Jun Yu  6
Affiliations
Free article

A blood-based biomarker panel for non-invasive diagnosis of metabolic dysfunction-associated steatohepatitis

Xiang Zhang et al. Cell Metab. .
Free article

Abstract

The current diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) and its severe form, metabolic dysfunction-associated steatohepatitis (MASH), is suboptimal. Here, we recruited 700 individuals, including 184 from Hong Kong as a discovery cohort and 516 from San Diego, Wenzhou, and Hong Kong as three validation cohorts. A panel of 3 parameters (C-X-C motif chemokine ligand 10 [CXCL10], cytokeratin 18 fragments M30 [CK-18], and adjusted body mass index [BMI]) was formulated (termed N3-MASH), which discriminated patients with MASLD from healthy controls with an area under the receiver operating characteristic (AUROC) of 0.954. Among patients with MASLD, N3-MASH could identify patients with MASH with an AUROC of 0.823, achieving 90.0% specificity, 62.9% sensitivity, and 88.6% positive predictive value. The diagnostic performance of N3-MASH was confirmed in three validation cohorts with AUROC of 0.802, 0.805, and 0.823, respectively. Additionally, N3-MASH identifies patients with MASH improvement with an AUROC of 0.857. In summary, we developed a robust blood-based panel for the non-invasive diagnosis of MASH, which might help clinicians reduce unnecessary liver biopsies.

Keywords: MASH; MASLD; N3-MASH; diagnosis; markers; multi-cohort; non-invasive; serum.

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Conflict of interest statement

Declaration of interests R.L. serves as a consultant to Aardvark Therapeutics, Altimmune, Arrowhead Pharmaceuticals, AstraZeneca, Cascade Pharmaceuticals, Eli Lilly, Gilead, Glympse bio, Inipharma, Intercept, Inventiva, Ionis, Janssen Inc., Lipidio, Madrigal, Neurobo, Novo Nordisk, Merck, Pfizer, Sagimet, 89 bio, Takeda, Terns Pharmaceuticals, and Viking Therapeutics. In addition, his institution received research grants from Arrowhead Pharmaceuticals, Astrazeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Eli Lilly, Galectin Therapeutics, Gilead, Intercept, Hanmi, Intercept, Inventiva, Ionis, Janssen, Madrigal Pharmaceuticals, Merck, Novo Nordisk, Pfizer, Sonic Incytes, and Terns Pharmaceuticals. He is a co-founder of LipoNexus Inc. V.W.-S.W. has served as an advisory board member or consultant for AbbVie, Boehringer Ingelheim, Echosens, Gilead Sciences, Intercept, Inventiva, Novo Nordisk, Pfizer, Sagimet Biosciences, TARGET PharmaSolutions, and Visirna and as a speaker for Abbott, AbbVie, Gilead Sciences, Novo Nordisk, and Unilab. He has received a research grant from Gilead Sciences and is a co-founder of Illuminatio Medical Technology Limited. V.W.-S.W. serves as a consultant or advisory board member for AbbVie, Boehringer Ingelheim, Echosens, Gilead Sciences, Intercept, Inventiva, Novo Nordisk, Pfizer, Sagimet Biosciences, and TARGET PharmaSolutions and as a speaker for Abbott, AbbVie, Gilead Sciences, and Novo Nordisk. He has received a grant from Gilead Sciences for fatty liver research and is a co-founder of Illuminatio Medical Technology Limited.

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