Ashraf Hami, Anushiravani Amir, Rayatpisheh Maryam, Hamidi Alamdari Daryoush, Hossieni Arianaz, Kazeminezhad Behrang
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Innovative Laboratory Assays in Biomedicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Front Med (Lausanne). 2025 Mar 12;12:1539605. doi: 10.3389/fmed.2025.1539605. eCollection 2025.
The exact mechanisms of non-alcoholic fatty liver disease (NAFLD), recently redefined as metabolic dysfunction-associated steatotic liver disease (MASLD), remain unclear. However, oxidative stress is recognized as a factor across all stages of NAFLD. The Pro-oxidant Antioxidant Balance (PAB) method is an important clinical tool that provides an assessment of the balance between oxidants and antioxidant. We aimed to explore oxidative stress in NAFLD using the PAB method.
Individuals with NAFLD were recruited in 2021. Eligible participants underwent detailed assessments, including liver elastography for fibrosis evaluation. Blood samples (5 mL) were collected to measure serum PAB levels. The METAVIR score, derived from FibroScan measurements of liver stiffness, categorized fibrosis severity from F0 (no fibrosis) to F4 (advanced fibrosis or cirrhosis).
The study included 102 participants, with a mean age of 50.12 ± 10.03 years. Significant correlations were observed between FibroScan scores and variables such as age, body mass index (BMI), history of chronic diseases, and family history of NAFLD. PAB levels were notably higher in patients with advanced fibrosis (F2 and F3 groups: 86.32 ± 25.53) compared to those in early stages (F0 and F1 groups: 45.36 ± 21.29). Moreover, FibroScan scores showed a significant positive association with PAB values (odds ratio [OR]: 1.07; 95% confidence interval (CI): 1.04, 1.10), even after adjusting for confounding variables (OR: 1.13; 95% CI: 1.07, 1.18).
Elevated PAB levels were strongly associated with advanced stages of liver fibrosis in NAFLD patients, reflecting increased oxidative stress with disease progression. These results highlight the potential of PAB as a marker for monitoring oxidative stress and disease severity in NAFLD. Nevertheless, further large-scale studies are warranted.
非酒精性脂肪性肝病（NAFLD）现重新定义为代谢功能障碍相关脂肪性肝病（MASLD），其确切机制仍不清楚。然而，氧化应激被认为是NAFLD各个阶段的一个因素。促氧化剂抗氧化剂平衡（PAB）方法是一种重要的临床工具，可用于评估氧化剂与抗氧化剂之间的平衡。我们旨在使用PAB方法探讨NAFLD中的氧化应激。
2021年招募了NAFLD患者。符合条件的参与者接受了详细评估，包括用于纤维化评估的肝脏弹性成像。采集5毫升血液样本以测量血清PAB水平。METAVIR评分源自肝脏硬度的FibroScan测量结果，将纤维化严重程度分为F0（无纤维化）至F4（晚期纤维化或肝硬化）。
该研究纳入了102名参与者，平均年龄为50.12±10.03岁。观察到FibroScan评分与年龄、体重指数（BMI）、慢性病史和NAFLD家族史等变量之间存在显著相关性。与早期阶段（F0和F1组：45.36±21.29）相比，晚期纤维化患者（F2和F3组：86.32±25.53）的PAB水平明显更高。此外，即使在调整混杂变量后，FibroScan评分与PAB值仍呈显著正相关（优势比[OR]：1.07；95%置信区间[CI]：1.04，1.10）（OR：1.13；95%CI：1.07，1.18）。
NAFLD患者中PAB水平升高与肝脏纤维化晚期密切相关，反映了随着疾病进展氧化应激增加。这些结果突出了PAB作为监测NAFLD氧化应激和疾病严重程度标志物的潜力。然而，仍需要进一步的大规模研究。
