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However, hepatic alterations influenced by enteric dysfunction in individuals with depression remain insufficiently investigated. The aim of the study is to investigate the associations between the non-invasive indices of hepatic steatosis and fibrosis and intestinal dysfunction biomarkers in patients with depressive disorders, taking into account the presence of MetS or its components, as well as dietary, behavioral and psychosocial factors, and antidepressant intake status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, data from 116 subjects were analyzed. The intestinal function blood biomarker citrulline (CIT) and gut permeability indicator Intestinal Fatty-Acid Binding Protein (I-FABP) were assessed alongside non-invasive liver-related parameters. Metabolic, dietary, and psychometric parameters were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median I-FABP and I-FABP\/CIT ratio values were higher in individuals with Fibrosis-4 (FIB-4) Index\u2009&gt;\u20091.3 than in those with FIB-4\u2009&lt;\u20091.3 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027 and r\n                      <jats:sub>rb<\/jats:sub>\n                      =0.447;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018 and r\n                      <jats:sub>rb<\/jats:sub>\n                      =0.479, respectively). In a logistic regression model with FIB-4\u2009&gt;\u20091.3 as the dependent variable, vegetable and seed consumption, CIT levels, waist circumference (WC) and quality of life were significant predictors, with WC being the most crucial (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019, OR\u2009=\u20091.1; 95% CI: 1.017-1.205). Additionally, subjects with Hepatic Steatosis Index (HSI)\u2009&gt;\u200936.0 who did not have concomitant MetS had higher CIT levels compared to those meeting both criteria (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016, r\n                      <jats:sub>rb<\/jats:sub>\n                      =0.529).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The association between FIB-4 and I-FABP seems to reflect an increased risk of hepatic abnormalities and related CVR in individuals with depression, particularly those with suspected intestinal permeability disturbances, with CIT serving as a significant predictor.. Reduced CIT levels in participants with MetS and liver dysfunction suggest greater impairment of gut integrity than in liver dysfunction alone. Conversely, individuals with liver dysfunction, in the absence of MetS, may have preserved intestinal function, as indicated by higher CIT concentrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      Trial was registered with the ClinicalTrials.gov registry (ClinicalTrials.gov ID: NCT04756544,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT04756544\" ext-link-type=\"uri\">https:\/\/clinicaltrials.gov\/study\/NCT04756544<\/jats:ext-link>\n                      , registration date: 11\/02\/2021).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-025-04559-7","type":"journal-article","created":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T01:34:28Z","timestamp":1767490468000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["I-FABP, citrulline and non-invasive liver dysfunction indices in patients with depression \u2013 cross-sectional study results"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7322-4844","authenticated-orcid":false,"given":"Jakub","family":"Rogalski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Grzelczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Margulska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Mirocha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gra\u017cyna","family":"Budryn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Strzelecki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliwia","family":"Gawlik-Kotelnicka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,3]]},"reference":[{"key":"4559_CR1","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1016\/J.CMET.2023.02.003","volume":"35","author":"NWS Chew","year":"2023","unstructured":"Chew NWS, Ng CH, Tan DJH, Kong G, Lin C, Chin YH, et al. 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