{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:48:56Z","timestamp":1792003736680,"version":"4.4.0"},"reference-count":33,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Hong Kong Research Grants Council","award":["AoE\/M\/707-18"],"award-info":[{"award-number":["AoE\/M\/707-18"]}]},{"name":"Hong Kong Health and Medical Research Fund","award":["08192316"],"award-info":[{"award-number":["08192316"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Metabolic associated fatty liver disease (MAFLD) is the hepatic manifestation of obesity-related metabolic syndrome (MetS). Noninvasive biomarkers for monitoring the progression and severity of these metabolic comorbidities are needed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To investigate the associations of serum thrombospondin-2 (TSP2) with MetS and MAFLD severity, and the potential diagnostic value of serum TSP2 for identifying at-risk metabolic associated steatohepatitis (MASH).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Blood samples, clinical data, and liver biopsies were collected from consecutively recruited 252 individuals with morbid obesity receiving bariatric surgery. Histopathology samples of liver biopsies were examined in a blinded fashion by 3 independent pathologists. Serum TSP2 levels were measured by enzyme-linked immunosorbent assay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Serum TSP2 levels were significantly elevated in MetS (1.58 [1.07-2.20] ng\/mL) compared with non-MetS (1.28 [0.84-1.73] ng\/mL; P\u2005=\u2005.006) in obese patients and positively correlated with increasing number of the MetS components, fasting glucose, glycated hemoglobin, fasting insulin, C-peptide, and homeostatic model assessment of insulin resistance after adjustment of conventional confounders. Serum TSP2 levels differentiated MASH (1.74 [1.32-3.09] ng\/mL) from the other non-MASH less severe groups: normal liver (1.41 [1.04-1.63] ng\/mL), simple steatosis (1.45 [0.89-1.92] ng\/mL), and borderline MASH (1.30 [0.99-2.17] ng\/mL) (P\u2005&amp;lt;\u2005.05). Elevated serum TSP2 was positively associated with the severity of hepatic steatosis, inflammation, fibrosis, and abnormal liver function independent of age, sex and adiposity. Furthermore, high serum TSP2 identified at-risk MASH with area under the operating curve of 0.84 (95% CI 0.70-0.98).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Serum TSP2 is closely associated with severity and progression of MetS and MAFLD, and is a promising noninvasive biomarker for differentiating MASH from benign steatosis and identifying at-risk MASH patients among individuals with obesity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgac292","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T14:28:27Z","timestamp":1652106507000},"page":"e3230-e3240","source":"Crossref","is-referenced-by-count":35,"title":["Serum Thrombospondin-2 Levels Are Closely Associated With the Severity of Metabolic Syndrome and Metabolic Associated Fatty Liver Disease"],"prefix":"10.1210","volume":"107","author":[{"given":"Xuerui","family":"Wu","sequence":"first","affiliation":[{"name":"State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong , Hong Kong , China"},{"name":"Department of Medicine, The University of Hong Kong , Hong Kong , China"},{"name":"Shenzhen Institute of Research and Innovation, The University of Hong Kong , Shenzhen , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia Kwan Yui","family":"Cheung","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong , Hong Kong , China"},{"name":"Department of Medicine, The University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dewei","family":"Ye","sequence":"additional","affiliation":[{"name":"Key Laboratory of Glucolipid Metabolic Diseases of the Ministry of Education, Guangdong Pharmaceutical University , Guangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subrata","family":"Chakrabarti","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Western University , Canada"},{"name":"Department of Pathology and Laboratory Medicine, London Health Sciences Centre , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hema","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Insititue of Clinical Pathology and Medical Research, Pathology West, NSW Health Pathology , Sydney, NSW 2145 , Australia"},{"name":"University of Sydney , New South Wales , Australia"},{"name":"Western Sydney University , New South Wales , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sen","family":"Yan","sequence":"additional","affiliation":[{"name":"Dr. Everett Chalmers Hospital , New Brunswick , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erfei","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University , Guangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wah","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University , Guangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7569-409X","authenticated-orcid":false,"given":"Chi Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong , Hong Kong , China"},{"name":"Department of Medicine, The University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Siu Ling","family":"Lam","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong , Hong Kong , China"},{"name":"Department of Medicine, The University of Hong Kong , Hong Kong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cunchuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University , Guangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0668-033X","authenticated-orcid":false,"given":"Aimin","family":"Xu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong , Hong Kong , China"},{"name":"Department of Medicine, The University of Hong Kong , Hong Kong , China"},{"name":"Shenzhen Institute of Research and Innovation, The University of Hong Kong , 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