@article{10902/37608,
year = {2025},
url = {https://hdl.handle.net/10902/37608},
abstract = {Background & Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide. Autoantibodies (Ab), such as antinuclear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), are frequently detected in MASLD, but their role in disease progression remains controversial. This study aimed to evaluate the prevalence of positive Ab and the histological features of autoimmune hepatitis (AIH) in MASLD and their association with liver-related outcomes.
Methods: We conducted a multicenter, retrospective, longitudinal study of patients with biopsy-proven MASLD from the HEPAmet Registry. Data on ANA (1/80), ASMA (1/40), and AIH histological features (portal inflammation, interface hepatitis, and plasma cell infiltration) were analyzed for their association with compensated advanced chronic liver disease (cACLD), liver decompensation, and death.
Results: Of the 460 patients (49% women, median age 58 years, median BMI 33 kg/m2, and 45% with advanced fibrosis), 17% and 25% tested positive for ANA and ASMA, respectively. Histological features of AIH included interface hepatitis (19%), moderate/severe portal inflammation (12%), and plasma cell clusters (10%). Possible AIH based on histological criteria was present in 8% of patients. The presence of positive Ab was independently associated with cACLD development (odds ratio 2.890, p <0.030), liver decompensation (hazard ratio 3.969, p = 0.001), and death (hazard ratio 2.546, p = 0.036). In contrast, the presence of isolated histologic autoimmune features was not correlated with serological markers and did not affect the prognosis of MASLD.
Conclusions: ANA and ASMA are commonly found in patients with MASLD and are associated with poorer liver-related outcomes and reduced survival, whereas isolated histological autoimmune features provide no additional prognostic value.},
organization = {AS is co-financed by CM23/00133, a Río Hortega grant funded by Instituto de
Salud Carlos III (ISCIII), Acción Estratégica en Salud, December 2023 Call, and
co-funded by the European Union. JMP is supported by a grant by Vall d’Hebron University Hospital Campus to intensify his research activity (2024-2025), funds
from European Commission/EFPIA IMI2 853966-2, IMI2 777377, H2020 847989,
HLTH-2023-TOOL-05-03, ISCIII PI19/01898 and PI22/01770, MICIN IBEC_-
ProyectCompl22, DTS24/00035, and “La Caixa” Foundation and Barcelona City
Council (COVID-SHINE and StopALD). Part of this work was supported by Project
"PI22/00776", funded by Instituto de Salud Carlos III (ISCIII) and co-funded by the
European Union and a grant by Pfizer NASH-ASPIRE program (77145101)
conceded to IG, and by a grant funded to MCL (PI21-0080) by Instituto de Salud
Carlos III, Proyectos de Investigación en Salud (proyectos FIS)–Acción Estratégica en Salud. Part of this work was supported by “Contractes Clínic de
Recerca Emili Letang - Josep Font” 2022, funded to IO by Hospital Clínic de
Barcelona. This study was supported by the Department of Recerca i Universitats
de la Generalitat de Catalunya (Code 2021- SGR-01331).},
publisher = {Elsevier},
publisher = {JHEP Reports, 2025, 7(19), 101470},
title = {Autoantibodies are associated with worse outcomes in MASLD},
author = {Soria, Anna and Díaz, Alba and Iruzubieta Coz, Paula and Martín-Mateos, Rosa and Salcedo-Allende, M. Teresa and Jiménez-Masip, Alba and Fuster-Anglada, Carla and Arias Loste, María Teresa and Perna, Cristian and El Maimouni, Cautar and Pericas, Juan Manuel and Ferrer-Gómez, Ana and Jiménez González, Carolina and Muñoz-Martínez, Sergio and Padilla, Marlene and Crespo, Javier and Calixto, Zyanya and Sabiote, Clara and Albillos, Agustín and Cervera, Marta},
}