Plasma pro-c3 as a surrogate indicator of steatosis and fibrosis in patients with metabolic dysfunction-associated fatty liver disease (MAFLD): A case-control study

Abstract

Liver biopsy remains the gold standard for diagnosis of steatosis and fibrosis in MAFLD patients, but due to its invasiveness and limitations, serum biomarkers of fibrogenesis were proposed as indicators of fibrosis and steatosis in MAFLD patients. Our study aims to to assess the performance of Plasma Pro-c3 as a surrogate biomarker in diagnosing the degree of steatosis and stage of fibrosis in MAFLD patients in comparison with transient elastography (Fibroscan®), ultrasongraphy, diagnostic panels such as FIB-4 score, APRI score, NAFLD fibrosis score, BARD score. We recruited 75 patients with MAFLD as well as 25 healthy controls, patients were stratified into groups based on the degree of steatosis and stage of fibrosis measured by FibroScan®.Group A, patients with steatosis, group B patients with MASH with persistent, elevated liver enzymes and, group C patients with MASH-fibrosis. Laboratory and radiological assessment were done for all research subjects. Plasma PRO-C3 demonstrated good diagnostic performance for detecting fibrosis in MAFLD patients with 89% sensitivity, 84% specificity, accuracy 91.3% in differentiating MAFLD patients from control with cut-off value of > 12 ng/dl with area under ROC curve equals 0.9 (0.80-0.90), also differentiating steatohepatitis from steatosis sensitivity 56%, specificity 72% with cut off >22. Plasma PRO-C3 shows promise as a non-invasive biomarker for detecting both steatosis and fibrosis in MAFLD patients.