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<p>We evaluated the prognostic performance of the metabolic vulnerability index (MVX), reflective of inflammation and amino acid dysmetabolism, in a cohort (<i>n</i> = 1613) with the full histological spectrum of MASLD. Over a median follow up of 4 years, MVX predicts all-cause mortality (H.R. 2.7 (95% CI = 2.1-3.5) for every 10-point increment; <i>p</i> &lt; 0.001), liver-related mortality (H.R. 5.1 (95% CI = 2.8-9.1); <i>p</i> &lt; 0.001), hepatic decompensation (H.R. 2.5 (95% CI = 1.8-3.4); <i>p</i> &lt; 0.001), a rise in model for end-stage liver disease (MELD) score to ≥ 15 (H.R. 1.8 (1.4-2.2); <i>p</i> &lt; 0.001) and a decline in eGFR ≥ 40% (H.R. 1.5 (95% CI = 1.2-1.8); <i>p</i> &lt; 0.001). A combination of fibrosis stage and MVX is superior to fibrosis stage alone for prediction of all-cause mortality (AUROC 0.79 vs 0.72, <i>p</i> = 0.01), liver-related mortality (0.95 vs 0.84, <i>p</i> = 0.002) hepatic decompensation (0.88 vs 0.86, <i>p</i> = 0.01) and hepatocellular cancer (0.84 vs 0.78, <i>p</i> = 0.001). These data support further development of MVX as a prognostic biomarker in MASLD.</p>

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The metabolic vulnerability index predicts outcomes in patients with metabolic dysfunction associated steatotic liver disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月23日

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  • Mohammad S. Siddiqui,
  • Mark L. Van Natta,
  • Margery A. Connelly,
  • Jeanne Clark,
  • Brent A. Neuschwander-Tetri,
  • Anna Mae Diehl,
  • Srinivasan Dasarathy,
  • Rohit Loomba,
  • Naga Chalasani,
  • Kris V. Kowdley,
  • Bilal Hameed,
  • Laura A. Wilson,
  • Katherine P. Yates,
  • Patricia Belt,
  • David E. Kleiner,
  • Cynthia Behling,
  • James Tonascia,
  • Arun J. Sanyal

摘要

We evaluated the prognostic performance of the metabolic vulnerability index (MVX), reflective of inflammation and amino acid dysmetabolism, in a cohort (n = 1613) with the full histological spectrum of MASLD. Over a median follow up of 4 years, MVX predicts all-cause mortality (H.R. 2.7 (95% CI = 2.1-3.5) for every 10-point increment; p < 0.001), liver-related mortality (H.R. 5.1 (95% CI = 2.8-9.1); p < 0.001), hepatic decompensation (H.R. 2.5 (95% CI = 1.8-3.4); p < 0.001), a rise in model for end-stage liver disease (MELD) score to ≥ 15 (H.R. 1.8 (1.4-2.2); p < 0.001) and a decline in eGFR ≥ 40% (H.R. 1.5 (95% CI = 1.2-1.8); p < 0.001). A combination of fibrosis stage and MVX is superior to fibrosis stage alone for prediction of all-cause mortality (AUROC 0.79 vs 0.72, p = 0.01), liver-related mortality (0.95 vs 0.84, p = 0.002) hepatic decompensation (0.88 vs 0.86, p = 0.01) and hepatocellular cancer (0.84 vs 0.78, p = 0.001). These data support further development of MVX as a prognostic biomarker in MASLD.