Diabetol Metab Syndr. 2025 Sep 24;17(1):370. doi: 10.1186/s13098-025-01931-1.
ABSTRACT
BACKGROUND: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a prevalent metabolic condition lacking sensitive and accessible biomarkers for early detection and risk stratification.
OBJECTIVE: To investigate the association between serum alpha-1-acid glycoprotein (AGP) levels and MAFLD prevalence among young and middle-aged women, and to evaluate the dose-response relationship and diagnostic performance of AGP.
METHODS: Data were obtained from 2,003 female participants aged 20-49 years in the NHANES 2017-2020 cycles. Weighted multivariable logistic regression models assessed the association between AGP and MAFLD, with adjustments for demographic, metabolic, and inflammatory covariates. Restricted cubic spline (RCS) regression evaluated nonlinear trends, and ROC analysis assessed predictive accuracy.
RESULTS: Higher AGP levels were significantly associated with increased MAFLD risk. In the fully adjusted model, the highest AGP tertile had an odds ratio of 2.63 (95% CI: 1.65-4.19) compared to the lowest. RCS analysis showed a nonlinear, biphasic relationship with an inflection point around 0.9 g/L. ROC analysis indicated moderate discriminatory ability (AUC = 0.734), with AGP outperforming traditional liver enzymes. Subgroup analyses confirmed consistency across metabolic risk strata.
CONCLUSION: AGP is independently and nonlinearly associated with MAFLD and may serve as a non-invasive biomarker for early identification of at-risk individuals. These findings support the potential clinical utility of AGP in MAFLD screening and risk assessment.
PMID:40993765 | DOI:10.1186/s13098-025-01931-1
