Evidence mapPaperPMID 41225403Full record

ArticleBMC gastroenterology2025

Serum complement C3 as a diagnostic biomarker for metabolic dysfunction -associated steatotic liver disease in middle-aged and elderly adults: a cross-sectional study.

Dan Ye, Haifen Ma, Jingjing Zhou, Jiaofeng Wang, Jiaheng Shi, Jie Chen, Zhijun Bao, Xiaona Hu

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Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Dan Ye *Department of Gastroenterology, Huadong Hospital Affiliated with Fudan University, Shanghai, China.
Haifen Ma *Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.
Jingjing Zhou *Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.
Jiaofeng WangShanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China.
Jiaheng ShiDepartment of Gastroenterology, Huadong Hospital Affiliated with Fudan University, Shanghai, China.
Jie ChenShanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China. laughchen@126.com.
Zhijun BaoDepartment of Gastroenterology, Huadong Hospital Affiliated with Fudan University, Shanghai, China. zhijunbao@fudan.edu.cn.
Xiaona HuDepartment of Gastroenterology, Huadong Hospital Affiliated with Fudan University, Shanghai, China. huxn06@163.com.

Funding

China Foundation For Youth Entrepreneurship And Employment P24062387784Key Discipline Projects of Huadong Hospital LCZX2202Key Specialization Diseases Construction of Huadong Hospital ZDZB2225Shanghai Municipal Health Commission JKKPYL-2022-15Shanghai Outstanding Young Medical Personnel Training Program & Excellence Project of the Shanghai Municipal Health Commission 20224Z0009
6 · The paper itself

Abstract

backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease globally, with significant liver fibrosis (SLF) determining clinical outcomes. Although complement activation is involved in MASLD pathogenesis, the clinical significance of circulating complement proteins (C1q, C3, C4, total activity) in aging populations remains unclear. This cross-sectional study aimed to evaluate the association between serum complement levels and MASLD/SLF in middle-aged and elderly adults.

methodsWe recruited 266 consecutive MASLD patients (age ≥ 45) and 150 age- and sex-matched healthy controls from Huadong Hospital. Multivariate logistic regression identified independent predictors of MASLD and SLF. Nonlinear relationships were assessed using restricted cubic splines. Spearman's correlation and mediation analyses explored clinical associations, while ROC curves evaluated diagnostic performance against established non-invasive indices.

resultsMASLD patients showed significantly higher levels of C1q, C3, C4, and total complement activity than controls (P < 0.05). After multivariate adjustment, C3 was independently associated with MASLD (OR = 1.04 per mg/dL, 95% CI: 1.02-1.06; P < 0.001). A nonlinear, inverted U-shaped relationship was observed between C3 and MASLD risk (P = 0.015), with peak risk at 143 mg/dL (OR = 2.53). C3 demonstrated high diagnostic accuracy for MASLD (AUC = 0.80, 95% CI: 0.75-0.85), comparable to validated models. Although lower C3 and C4 were associated with SLF in univariate analysis, this was not sustained after adjustment. No significant association was found between complement levels and SLF.

conclusionsSerum C3 is a promising diagnostic biomarker for MASLD in middle-aged and elderly adults, showing a distinct nonlinear relationship and strong discriminative ability. However, complement levels were not independently associated with liver fibrosis in this population. These findings suggest a potential role for C3 in MASLD diagnosis, but the cross-sectional design precludes causal inference, and further longitudinal studies are needed to confirm its clinical utility and elucidate underlying mechanisms.

Indexed as

Complement C3Fatty LiverAgedBiomarkersCase-Control StudiesComplement C1qComplement C4Cross-Sectional StudiesFemaleHumansLiver CirrhosisMaleMiddle AgedROC CurveBiomarkersComplement C1qComplement C3Complement C4Complement proteinLiver fibrosisMetabolic dysfunction-associated steatotic liver diseaseMiddle-aged and elderly population

Identifiers

PMID41225403
PMCPMC12613586

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.