{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:48:37Z","timestamp":1787028517913,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:00:00Z","timestamp":1687996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003407","name":"Ministero dell\u2019istruzione, dell\u2019Universit\u00e0 e della Ricerca","doi-asserted-by":"publisher","award":["PRIN2017 E64I19000590001"],"award-info":[{"award-number":["PRIN2017 E64I19000590001"]}],"id":[{"id":"10.13039\/501100003407","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Visceral obesity is linked to the progression of fatty liver to nonalcoholic steatohepatitis (NASH). Cytokeratin-18 (CK18) epitopes M30 (CK18M30) and M65 (CK18M65) represent accurate markers for detecting NASH. The aim of this study was to evaluate the association of CK18M30 and CK18M65 levels with anthropometric and metabolic characteristics, liver stiffness, and liver indices of steatosis and fibrosis in a cohort of subjects with visceral obesity; in this cross-sectional study, transient elastography (TE-Fibroscan\u00ae), anthropometric measurements, metabolic parameters, High Sensitivity C-Reactive Protein (hsCRP), and CK18M30 and CK18M65 levels (Apoptosense ELISA, PEVIVA, Germany) were evaluated. Fatty Liver Index (FLI), Fibrosis 4 (FIB-4), and Aspartate transaminase (AST)-platelet ratio index (APRI) were calculated; among 48 subjects, 47.2% presented metabolic syndrome, 93.8% hepatic steatosis, 60.4% high liver stiffness, and 14.6% hypertransminasemia, while FIB-4 and APRI were normal. CK18M30 and CK18M65 levels were significantly correlated with waist circumference, AST, ALT, HoMA-IR, liver stiffness, and APRI (p &lt; 0.001). Subjects with CK18 fragments above the median values showed significantly higher waist circumference, HbA1c, AST, ALT, HoMA-IR, FLI, and APRI compared to those with values below the median; CK18M30 and CK18M65 levels correlated well with anthropometric and metabolic characteristics, representing good biomarkers for early identification of NASH in subjects with visceral obesity.<\/jats:p>","DOI":"10.3390\/ijms241310885","type":"journal-article","created":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T00:43:30Z","timestamp":1688085810000},"page":"10885","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Visceral Obesity and Cytokeratin-18 Antigens as Early Biomarkers of Liver Damage"],"prefix":"10.3390","volume":"24","author":[{"given":"Giulia","family":"de Alteriis","sequence":"first","affiliation":[{"name":"Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II\u201d, Via Sergio Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II\u201d, Via Sergio Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Di Sarno","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II\u201d, Via Sergio Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Muscogiuri","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II\u201d, Via Sergio Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9054-456X","authenticated-orcid":false,"given":"Luigi","family":"Barrea","sequence":"additional","affiliation":[{"name":"Department of Humanities, Telematic University Pegaso, 80143 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0000-1076","authenticated-orcid":false,"given":"Valentina","family":"Cossiga","sequence":"additional","affiliation":[{"name":"Diseases of the Liver and Biliary System Unit, Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0479-8729","authenticated-orcid":false,"given":"Giuseppe","family":"Perruolo","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1376-3782","authenticated-orcid":false,"given":"Michele Francesco","family":"Di Tolla","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Zumbolo","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II\u201d, Via Sergio Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7020-6870","authenticated-orcid":false,"given":"Pietro","family":"Formisano","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filomena","family":"Morisco","sequence":"additional","affiliation":[{"name":"Diseases of the Liver and Biliary System Unit, Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3211-4307","authenticated-orcid":false,"given":"Silvia","family":"Savastano","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II\u201d, Via Sergio Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,29]]},"reference":[{"key":"ref_1","first-page":"e29657","article-title":"Multidisciplinary Approach and Current Perspective of Nonalcoholic Fatty Liver Disease: A Systematic 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