Noninvasive fibrosis triage in MASLD: diagnostic performance of endocan and endoglin (cross-sectional study)

OBJECTIVES: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most globally prevalent chronic liver disorder. Thus, this study aimed to evaluate the association of serum endocan and endoglin levels with fibrosis severity in patients with MASLD. METHODS: In the study, between December 2023 and November 2024, 58 MASLD patients and 30 healthy controls were enrolled; sample size was based on a power analysis. Vibration-controlled transient elastography, reporting controlled attenuation parameter, and liver stiffness in kilopascals was used to quantify hepatic steatosis and fibrosis, and serum endocan and endoglin levels were measured. Comparisons were made between the MASLD and control groups, and within the MASLD group between patients with advanced-stage fibrosis versus those with lower-stage fibrosis. Discriminative ability of the biomarkers was evaluated by receiver operating characteristic (ROC) analysis. Independent associations between serum biomarkers and kilopascals values in the patient group were assessed by regression analysis. RESULTS: Serum endocan and endoglin were significantly elevated in the MASLD group compared with controls. In the MASLD group, patients with advanced fibrosis exhibited higher endocan and endoglin levels than those with lower-stage fibrosis. In ROC analysis for discriminating advanced fibrosis, endoglin demonstrated strong discriminative ability and endocan exhibited good accuracy for fibrosis assessment. Multivariate regression analysis revealed that log-transformed kilopascals values were independently associated with serum endocan and endoglin. CONCLUSION: Endoglin and endocan are promising, accessible noninvasive biomarkers that may support fibrosis triage and referral decisions in general internal medicine for MASLD. Prospective validation is warranted.