Serum Galectin 3 Level as a Non-Invasive Biomarker of MAFLD Severity
Authors: Samy Amir Helmy , Elbaz Hossam Samir , Elsayed Hussein Mohamed Ahmed , Hashem Walaa Mohamed 
Published: November 2024

Abstract

Background
Metabolic dysfunction-associated fatty liver disease (MAFLD) has become one of the most relevant forms of chronic liver disease worldwide due to the progressively increased in obesity rate. It is increasingly clear that subjects with MAFLD and especially those with significant fibrosis are at greatest risk of mortality and adverse clinical outcomes.

Aim of the Work
The present study was to evaluate the association of galactin-3 with the degree of steatosis and fibrosis in obese patients with MAFLD.

Patients and Methods
This case-control study was performed on 60 Egyptian patients who have MAFLD. Patients with MAFLD were divided into 3 subgroups according to the severity by the degree of fibrosis and steatosis (mild, moderate and severe). An age and gender matched control group comprised of 30 healthy volunteers were recruited as control group. They were recruited and assessed for eligibility from the Internal Medicine, Hepatology and Gastroenterology Department and Outpatient Clinic at Ain Shams University Hospital.

Results
Regarding the anthropometric measurements, the present study indicated the presence of a statistically significant increase in the mean SBP, DBP, BMI and WC among MAFLD group compared with the control group. Among the cases group, there was a statistically significant increase in the SBP, DBP, BMI and WC among the moderate and severe cases compared with the mild cases. Regarding the calculated scores of the studied groups, the present study revealed a statistically significant increase in fibrosis scores fibrosis-4 score (FIB-4), Aspartate aminotransferase -to-Platelet Ratio Index (APRI) score and NAFLD Fibrosis score (NFS), and among the cases compared with the control groups (P value&lt;0.001). Among the cases group, there was a statistically significant increase in FIB-4 score, APRI and NFS score among the severe cases compared with moderate and mild cases (P value&lt;0.001). Regarding the Correlation analysis, serum galactin-3 showed that there was a statistically significant positive correlation with BMI, WC, AST, ALT, total bilirubin, PT, PTT, creatinine, urea, FBS, HbA1c HOMA-IR, LDL, T-cholesterol, TGs, CRP, FIB-4, APRI, NFS, and scores of fibrosis and steatosis by TE. there was a statistically significant negative correlation with PLT, HDL, and albumin. The present study revealed a statistically significant increase in serum galactin-3 level among the cases compared with the control group. Among the cases group, there was a statistically significant increase in serum galactin-3 level among severe cases compared with moderate and mild cases. Regarding the diagnostic performance of serum galectin-3 for prediction of severity of MAFLD among obese patients, the present study revealed that the AUC value (the AUC for serum galactin-3 was. 0989 with the best cutoff value ≥ 9.88 with sensitivity = 96.7% and specificity = 93.3% and accuracy 95.6%). Regarding the diagnostic performance of serum galectin-3 for prediction of mild steatosis in MAFLD patients, the present study revealed that the (AUC value was. 0966 with the best cutoff value ≥ 9.15 with sensitivity = 95% and specificity = 93.3% and accuracy 94%). Regarding the diagnostic performance of serum galectin-3 in predicting severe steatosis in patients, the present study revealed that the (AUC value was 1.0 with the best cutoff value ≥ 17.74 with sensitivity = 100% and specificity = 100% and accuracy 100 %).

Conclusion
Serum galactin-3 is elevated in patients with MAFLD with a tendency toward high levels in cases with severe steatosis. Galactin-3 is positively correlated with deterioration of parameters indicating liver function. Galactin-3 had the best sensitivity = 96.7% and specificity = 93.3% at a cutoff value ≥ 9.88 for predecting MAFLD among obese patients.