Evidence mapPaperPMID 42437923Full record

ArticleCardiovascular diabetology2026

Sex- and menopause-specific inverse associations between metabolic dysfunction-associated steatotic liver disease and serum lipoprotein(a) concentrations: evidence from SHIP and UK Biobank.

Júlia Galbiati de Souza, Till Ittermann, Nicole Werner, Sabine Schipf, Nele Friedrich, Matthias Nauck, Marcio Hiroshi Miname, Fábio Fernandes, Raul Dias Santos, Jelena-Rima Ghadri and 7 more

Abstract readComparative Study
In one paragraph

Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

17 authors.

Júlia Galbiati de Souza *Postgraduate Program in Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Till Ittermann *Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Nicole WernerDepartment of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Sabine SchipfDepartment of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Nele FriedrichGerman Centre for Cardiovascular Research (DZHK), Partner Site North, Greifswald, Germany.
Matthias NauckGerman Centre for Cardiovascular Research (DZHK), Partner Site North, Greifswald, Germany.
Marcio Hiroshi MinameLipid Clinic, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Fábio FernandesCardiomyopathy Unit, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Raul Dias SantosLipid Clinic, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Jelena-Rima GhadriGerman Centre for Cardiovascular Research (DZHK), Partner Site North, Greifswald, Germany.
Davide Di VeceDepartment of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.
Martin BahlsGerman Centre for Cardiovascular Research (DZHK), Partner Site North, Greifswald, Germany.
Giovanni TargherMetabolic Diseases Research Unit, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella, Italy.
Elisabeth Steinhagen-ThiessenLipid Clinic at the Interdisciplinary Metabolism Center, Charité - University Medicine Berlin, Berlin, Germany.
Christian TemplinGerman Centre for Cardiovascular Research (DZHK), Partner Site North, Greifswald, Germany.
Nágila Raquel Teixeira Damasceno *Postgraduate Program in Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Marcello Ricardo Paulista Markus *German Centre for Cardiovascular Research (DZHK), Partner Site North, Greifswald, Germany. marcello.markus@uni-greifswald.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe association between metabolic dysfunction-associated steatotic liver disease (MASLD) and serum lipoprotein(a) (Lp[a]) levels remains controversial, with no sex- or menopausal status-stratified analyses. We aimed to analyse the associations between MASLD, liver fat content (LFC) and transaminases with Lp(a) concentrations stratified by sex and menopausal status.

methodsWe analysed data from 3825 individuals (1961 females; 51.3%) aged 32 to 70 years from the SHIP-START-0 cohort, and from 28,504 individuals (14,926 females; 52.4%) aged 38 to 72 years from the UK Biobank cohort. MASLD was determined by liver ultrasound examinations in SHIP-STAR-0 and by magnetic resonance imaging in UK Biobank. We examined sex- and menopausal status-specific associations of MASLD, LFC, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) with lipoprotein(a) [Lp(a)] concentrations, after adjustment for age, body mass index, haemoglobin A1c, glucose-lowering medication use, hypertension, smoking, and alcohol consumption.

resultsIn SHIP-START-0, MASLD, higher ALT, AST, and GGT levels were independently associated with lower Lp(a) concentrations only in males but not in females. However, after stratification by menopausal status, higher ALT levels were associated with lower Lp(a) concentrations in postmenopausal females, but not in premenopausal females. In UK Biobank, MASLD severity (moderate and severe), higher LFC, and higher serum transaminase levels were independently associated with lower Lp(a) concentrations in males. Higher LFC was also associated with lower Lp(a) concentrations in females, but serum liver enzymes were not. After stratification by menopausal status, MASLD severity and higher LFC were associated with lower Lp(a) concentrations in postmenopausal females, but not in premenopausal females. Males with MASLD had 24% and 9% lower Lp(a) concentrations than those without MASLD in SHIP-START-0 and UK Biobank.

conclusionsOur findings from two large community-based studies show that MASLD and higher LFC and ALT values were independently associated with lower Lp(a) concentrations in postmenopausal females and males. Future studies are needed to determine whether the cardiovascular risk in patients with MASLD remains elevated even when Lp(a) concentrations are reduced and whether these patients require more intensive treatment to further reduce Lp(a) concentrations below the currently recommended cut-off values.

Indexed as

Fatty LiverLipoprotein(a)MenopauseNon-alcoholic Fatty Liver DiseaseAdultAgedBiological Specimen BanksBiomarkersFemaleHumansLiverMaleMiddle AgedRisk AssessmentRisk FactorsSex FactorsBiomarkersLipoprotein(a)LPA protein, humanArterial stiffnessConcentric remodellingDiabetes mellitusInsulin resistancePrediabetes

Identifiers

PMID42437923
PMCPMC13366839

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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.