{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T11:32:34Z","timestamp":1762342354082,"version":"3.40.5"},"reference-count":46,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Adaptive immunity is gaining a significant role in progression of metabolic dysfunction\u2010associated steatotic liver disease (MASLD). B\u2010cell activity can be assessed by serum\u2010free light chains (sFLCs) k and \u03bb levels. The objective of the present investigation is to examine the utility of sFLCs as non\u2010invasive biomarkers for the stratification of MASLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled a consecutive cohort from an outpatient liver unit. Diagnosis of metabolic dysfunction\u2010associated steatohepatitis (MASH) was made with liver biopsy according to current guidelines. Compensated advanced chronic liver disease (cACLD) and clinically significant portal hypertension (CSPH) were defined according to Baveno VII criteria. sFLCs were measured by turbidimetry using an immunoassay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We evaluated 254 patients, 162\/254 (63.8%) were male. Median age was 54\u2009years old, and the median body mass index was 28.4\u2009kg\/m<jats:sup>2<\/jats:sup>. A total of 157\/254 (61.8%) subjects underwent liver biopsy: 88 had histological diagnosis of MASH, 89 were considered as simple metabolic dysfunction\u2010associated steatotic liver (MASL) and 77\/254 (30.3%) patients with compensated metabolic dysfunction\u2010associated cirrhosis. By using Baveno VII criteria, 101\/254 (39.7%) patients had cACLD; among them, 45\/101 (44.5%) had CSPH. Patients with cACLD showed higher sFLC levels compared with patients without cACLD (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01), and patients with CSPH showed higher sFLC levels than patients without CSPH (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). At multivariable analysis, sFLCs were associated with cACLD (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) independently from \u03b3\u2010globulins and other known dysmetabolic risk factors. \u03baFLC was associated with CSPH (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) independently from \u03b3\u2010globulins and other known dysmetabolic risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>sFLCs could be a simple biomarker for stratification of cACLD in MASLD patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.16036","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T12:43:44Z","timestamp":1721220224000},"page":"2625-2638","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Serum\u2010free light chains as a dependable biomarker for stratifying patients with metabolic dysfunction\u2010associated steatotic liver disease"],"prefix":"10.1111","volume":"44","author":[{"given":"Antonio","family":"Liguori","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences Fondazione Policlinico Universitario A. 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Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Cristina","family":"Giustiniani","sequence":"additional","affiliation":[{"name":"Department of Women, Children and Public Health Sciences Fondazione Policlinico Universitario A, Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Pompili","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"},{"name":"Department of Translational Medicine and Surgery Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0544-8993","authenticated-orcid":false,"given":"Antonio","family":"Grieco","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Fondazione Policlinico Universitario A. 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