Predictive Value of Serum Mac-2 Binding Protein Glycosylation Isomer for Hepatic Fibrosis in Hepatitis C Virus-Infected Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease.

BACKGROUND

The diagnostic accuracy and optimal cutoff values of serum Mac-2 binding protein glycosylation isomer (M2BPGi) for predicting hepatic fibrosis severity in hepatitis C virus (HCV)-infected patients with and without metabolic dysfunction-associated steatotic liver disease (MASLD) remain uncertain.

METHODS

We recruited 2064 patients with available M2BPGi data and valid vibration-controlled transient elastography (VCTE) results. The areas under the receiver operating characteristic curves (AUROCs) with 95% confidence intervals (CIs) of M2BPGi were compared between MASLD and non-MASLD groups for fibrosis stages of ≥F2, ≥F3, and F4. M2BPGi cutoff values were determined for the maximal Youden index, positive likelihood ratio (LR+) nearest to ≥10, and negative LR (LR-) nearest to ≤0.1.

RESULTS

At the same fibrosis stage, serum M2BPGi levels were significantly higher in MASLD patients than in non-MASLD patients (F0-F1: 1.12 versus 1.01, p = 0.011; F2: 2.02 versus 1.93, p = 0.013; F3: 3.13 versus 3.08, p = 0.023; F4: 5.32 versus 4.91, p = 0.003). The AUROCs of M2BPGi were comparable between MASLD and non-MASLD groups for ≥F2 (0.899 [95% CI: 0.878-0.919] versus 0.889 [95% CI: 0.871-0.908]), ≥F3 (0.914 [95% CI: 0.892-0.936] versus 0.934 [95% CI: 0.915-0.952]), and F4 (0.917 [95% CI: 0.894-0.941] versus 0.953 [95% CI: 0.937-0.968]). Optimal cutoff levels for all criteria were higher in patients with MASLD.

CONCLUSIONS

Serum M2BPGi is a reliable marker for assessing hepatic fibrosis severity in HCV patients. However, optimal cutoff values should be adjusted according to MASLD status to improve diagnostic accuracy.