Relationship Between Metabolic DysfunctionAssociated Steatotic Liver Disease and Lipoprotein (a) and Other Biomarkers

Background: Metabolic dysfunction -associated steatotic liver disease (MASLD) primarily affects the adult population and is closely related to obesity. The most severe form of MASLD, metabolic dysfunctionassociated steatohepatitis (MASH), can progress to liver fibrosis. While lipoprotein(a) (Lp(a)) is known to be associated with cardiovascular disease, its relationship with MASLD remains unclear. This study aims to determine the prevalence of MASLD in ambulatory patients and to explore the association between Lp(a) levels and advanced liver damage. Methods: This retrospective cross-sectional study included 130 patients older than 18 years seen in a healthcare center in Medellin, Colombia, between April 2023 and May 2024. Sociodemographic, clinical, and specific biomarker data were collected. Patients with cirrhosis, previous liver disease, frequent alcohol consumption, cancer, and other severe conditions were excluded. Continuous variables were analyzed using Student's t -tests or Mann -Whitney tests according to their distribution, and categorical variables were analyzed using contingency tables and chi-square tests. Results: Of the 130 patients, 57.9% (n=73) had MASLD, with a higher prevalence in patients with obesity (80%, n=32). Lp(a) levels were abnormally high in 43.1% (n=31) of patients; however, a weak but significant inverse correlation was found between Lp(a) levels and the Fibrosis -4 (FIB -4) score, which is used to assess the severity of liver fibrosis. Patients with MASLD had significantly lower high -density lipoprotein (HDL) and vitamin D levels, and higher levels of gamma-glutamyl transferase (GGT). Conclusions: This study highlights the significant prevalence of MASLD in outpatients and its relationship with various biomarkers, including Lp(a), HDL, vitamin D, and GGT. Although the findings suggest a possible utility of Lp(a) as a biomarker in MASLD, longitudinal studies are needed to confirm these associations and clarify their role in liver disease progression. The study's limitations include its cross-sectional nature and potential selection bias, indicating the need for further research to validate these results.