Circulating Asprosin and Neuregulin-4 in metabolic dysfunction-associated steatotic liver disease (MASLD): A systematic review and meta-analysis

Abstract

Background

Adipokines, such as asprosin and neuregulin 4 (Nrg4), are implicated in the pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD) and may function as potential diagnostic biomarkers and therapeutic targets. The objective of this meta-analysis is to compare the circulating levels of asprosin and Nrg4 between populations with MASLD and those without the condition.

Methods

A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. Databases including PubMed, Scopus, and Europe PMC were systematically searched for observational studies published until October 7, 2024. Inclusion criteria consisted of studies that reported extractable data on circulating asprosin and Nrg4 in populations with and without MASLD. Random-effects models were employed to calculate standardized mean differences (SMDs) and mean differences (MDs) with 95 % confidence intervals (CIs). Heterogeneity among studies was assessed using Cochrane's Q test, as well as I² and Tau² statistics. Furthermore, sensitivity analysis and publication bias were evaluated to ensure the robustness of the findings.

Results

Ten studies were included, with four analysing asprosin and six analysing Nrg4. Patients with MASLD exhibited significantly higher circulating asprosin levels (SMD = 0.82, 95 % CI: 0.49–1.15; p < 0.01; I² = 65 %) and lower Nrg4 levels (SMD = −1.12, 95 % CI: 1.77 to −0.46; p < 0.01; I² = 94 %) compared to non-MASLD individuals. Sensitivity analyses confirmed the robustness of these findings.

Conclusions

Elevated asprosin and reduced Nrg4 levels are associated with MASLD, highlighting their potential as biomarkers and therapeutic targets. Further studies are warranted to validate these findings.