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Publications

Journal Article Epublish

PubMed: 42589995 DOI: 10.3390/jcm15155892

Blood Urea Nitrogen to Serum Albumin Ratio Is Associated with MASH and Significant Fibrosis: Report from a Turkish Biopsy-Proven MASLD Cohort.

J Clin Med 15(15)

Authors: Ali Kirik, Eda Kaya, Caglayan Keklikkiran, Yusuf Yilmaz

Affiliations

  • Department of Internal Medicine, Balikesir University Medical School, Balikesir 10145, Türkiye.
  • The Global NASH Council (GNC), Washington, DC 20037, USA.
  • Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr-University Bochum, 44892 Bochum, Germany.
  • Department of Gastroenterology, School of Medicine, Recep Tayyip Erdogan University, Rize 53020, Türkiye.
  • Dijitalpark Teknokent, Ä°stanbul 34788, Türkiye.

Abstract

Background/Objectives: The blood urea nitrogen-to-serum albumin ratio (BAR) is a recently established index that has been associated with systemic inflammation. This study aimed to evaluate the association between BAR levels and histopathological findings in patients with biopsy-proven MASLD. Methods: A total of 425 biopsy-proven MASLD patients from the Turkish MASLD Biobank were included in the analysis. Histological assessments were performed according to the SAF/FLIP algorithm. The BAR was calculated as indicated. Results: The median age was 49 [19-71] and54% of the patients were male (n = 229). A total of 204 (48%) and 377 patients (88.7%) had significant fibrosis and metabolic dysfunction-associated steatohepatitis (MASH), respectively. BAR was significantly lower among patients with significant fibrosis [3.11 (0.21-9.41) vs. 3.41 (1.37-11.49), p = 0.002]. The same trend was observed among patients with MASH (3.2 [0.2-11.5] vs. 4.6 [1.9-8.7]), p < 0.001). Also, there is a decline beginning from F0 to F4 fibrosis (p = 0.014). In multivariate analysis, BAR remained an independent predictor after adjustment for confounders (OR 0.813, p = 0.020). BAR showed an AUROC of 0.586 (95% CI: 0.532-0.640) for predicting significant fibrosis. Conclusions: This is the first study to evaluate BAR levels in patients with biopsy-proven MASLD, demonstrating that BAR levels were inversely associated with the presence of significant fibrosis. These findings show an association between declining BAR levels and impaired liver health. However, the results should be interpreted cautiously owing to their suboptimal statistical performance.

MeSH

Serum Albumin, Blood, Serum, Urea, Fibrosis, Non-Alcoholic Fatty Liver Disease, Biopsy, Blood Urea Nitrogen