Pentraxin-3 as a poor marker of fibrosis in the course of metabolic dysfunction-associated steatotic liver disease (MASLD) in older adult population -results from the PolSenior2 substudy

Aleksander Jerzy Owczarek ¹ Joanna Musialik ¹ Adrian Stefański ² Małgorzata Mossakowska ³ Katarzyna Ziemba ¹ Andrzej Więcek ¹ Jerzy Chudek ¹ Magdalena Olszanecka-Glinianowicz ^1*

• ¹ Medical University of Silesia, Katowice, Poland
• ² Medical University of Gdansk, Gdańsk, Pomeranian, Poland
• ³ International Institute of Molecular and Cell Biology in Warsaw (IIMCB), Warsaw, Masovian, Poland

The study aimed to assess the relationship between plasma pentraxin 3 (PTX-3) levels and potential diagnosis of fibrosis in the course of metabolic dysfunction-associated steatohepatitis (MASH) based on FIB-4, NAFLD fibrosis scores (NFS), and Hepamet Fibrosis Score (HFS) in older adults.The subanalysis included 2397 older adults (60 years and older)participants of the population-based PolSenior2 study with risk factors of metabolic dysfunctionassociated steatotic liver disease (MASLD) and assessed PTX-3. The men and women were divided into two subgroups according to FIB-4 values (<2.67 and >2.67), three subgroups according to the NFS values (< -1.455, -1.455 and 0.675, and > 0.675), and HFS values (< 0.12, 0.12 and 0.47 and > 0.47).The empirical cut-off points for PTX-3 levels as a potential marker of liver fibrosis were assessed separately for women and men. The cut-off points for PTX-3 levels based on the ROC curve analyses, as a marker of liver fibrosis, ranged from 1.96 to 2.30 ng/mL (AUC from 0.596 to 0.643, sensitivity from 39.1% to 61.7%, specificity from 56.1% to 79.6%) in women, while in men significant cut-off point was established for FIB-4 (AUC 0.549, sensitivity 39.4%, specificity 69.6%). The accuracy was poor.Our study suggests that plasma PTX-3 levels are not sensitive enough to be used as a nonspecific marker of liver fibrosis in older adults.