Autoantibodies are associated with worse outcomes in MASLD

作者：Anna Sòria, Alba Díaz, Paula Iruzubieta, Rosa Martín‐Mateos, M.T. Allende, Alba Jiménez-Masip, Carla Fuster, M. Arias, Cristian Perna, Cautar El Maimouni, Juan M. Pericàs, Ana Ferrer‐Gomez, Carolina Jiménez-González, Sergio Muñoz, Marlene Padilla, Javier Crespo, Zyanya Calixto, Clara Sabiote, Agustín Albillos, Marta Cervera, Ignasi Olivas, Pinelopi Arvaniti, Helena Hernandéz Evole, Natalia Jiménez, Jordi Gratacós‐Ginès, Adrià Juanola, Elisa Pose, Mar Coll, Ruth Nadal, Martina Pérez, Núria Fabrellas, Pere Ginès, María‐Carlota Londoño, Isabel Graupera · 发表于：JHEP Reports · 年份：2025 · DOI：10.1016/j.jhepr.2025.101470 · 被引用次数：5 · 研究领域：Liver Diseases and Immunity、Liver Disease Diagnosis and Treatment、Diabetes and associated disorders

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: = 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. Impact and implications: Metabolic dysfunction-associated steatotic liver disease (MASLD) can coexist with other liver diseases, including autoimmune hepatitis. The role of autoan...