The Lipidomic Profile Discriminates Between MASLD and MetALD

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Kai Markus Schneider - , Department of Internal Medicine I, Center for Regenerative Therapies Dresden, Else Kröner Fresenius Center for Digital Health, RWTH Aachen University (Author)
  • Feng Cao - , RWTH Aachen University (Author)
  • Helen Ye Rim Huang - , RWTH Aachen University (Author)
  • Lanlan Chen - , Charité – Universitätsmedizin Berlin (Author)
  • Yazhou Chen - , RWTH Aachen University (Author)
  • Rongpeng Gong - , RWTH Aachen University (Author)
  • Anastasia Raptis - , RWTH Aachen University (Author)
  • Kate Townsend Creasy - , University of Pennsylvania (Author)
  • Jan Clusmann - , Else Kröner Fresenius Center for Digital Health, RWTH Aachen University (Author)
  • Felix van Haag - , RWTH Aachen University (Author)
  • Paul Henry Koop - , University Hospital Aachen (Author)
  • Adrien Guillot - , Charité – Universitätsmedizin Berlin (Author)
  • Tom Luedde - , Heinrich Heine University Düsseldorf (Author)
  • Rohit Loomba - , University of California at San Diego (Author)
  • Sven Francque - , University of Antwerp (Author)
  • Carolin Victoria Schneider - , RWTH Aachen University, University of Pennsylvania Perelman School of Medicine (Author)

Abstract

Background: The recent consensus statement redefined steatotic liver diseases. Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction and alcohol-related liver disease (MetALD) now represent distinct disease entities. However, biomarkers that differentiate MASLD and MetALD remain largely unknown. Aims: To identify lipidomic biomarkers with discriminatory potential for distinguishing MetALD from MASLD. Methods: Using the UK Biobank dataset, 40,534 people with available MRI liver scans were analysed. A total of, 11,217 cases with a proton density fat fraction (PDFF) ≥ 5% were identified as having steatotic liver disease. Among these, lipidomic profiles were obtained for 5539 MASLD and 462 MetALD cases. A total of, 250 plasma lipidomic and metabolomic parameters were analysed. Mendelian randomisation (MR) analysis was used to confirm the association between alcohol consumption and the lipidomic biomarkers. Results: When comparing the top 30 differentially expressed lipidomic biomarkers predicting MetALD compared to MASLD, the majority were related to HDL and were significantly overrepresented at both analysed time points. The top five metabolites were: acetoacetate, 3-hydroxybutyrate, phospholipids in Large HDL, concentration of large HDL particles, free cholesterol in large HDL. The sensitivity analysis comparing alcohol-related liver disease to MASLD revealed similar associations, suggesting that the HDL signature is stable over time. Additionally, MR analysis further confirmed that alcohol consumption was associated with increased levels of HDL-related metabolites. Conclusion: Our findings indicate that HDL-centric lipidomic markers, particularly those within the larger and medium HDL subfraction, may differentiate MetALD from MASLD. Further longitudinal and experimental studies are warranted to validate these findings and assess their clinical implications.

Details

Original languageEnglish
Pages (from-to)1357-1371
Number of pages15
JournalAlimentary Pharmacology and Therapeutics
Volume61
Issue number8
Publication statusPublished - Apr 2025
Peer-reviewedYes

External IDs

PubMed 39935287

Keywords

Keywords

  • ethanol metabolism, HDL, Lipidomics, liver disease, MASLD, MetALD, proton density fat fraction, UK biobank