{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:44:15Z","timestamp":1760240655988,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2019,8,17]],"date-time":"2019-08-17T00:00:00Z","timestamp":1566000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health Research Institute, IDIVAL","award":["NEXT-VAL 15\/12"],"award-info":[{"award-number":["NEXT-VAL 15\/12"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: we aimed to assess the influence of metabolic syndrome on fibrosis regression (using liver-stiffness measurement (LSM) and serological scores) and the relationship with the expression of lysyl oxidase-like-2 as a potential goal of antifibrotic therapy. Methods: We included 271 patients treated with Direct Antiviral Therapy (DAAs) in our hospital who achieved a sustained virological response (SVR); physical examination, blood tests, and LSM were made at baseline (B) and 24 months (24 M) after SVR. Hemodynamic studies and transjugular liver biopsies were performed on 13 patients. Results: At B, 68 patients were F1 (25.1%); F2 n = 59 (21.7%); F3 n = 44 (16.05%); and 100 were F4 (36.9%). Although the LSM (absolute value) improved in 82% of patients (n = 222), it progressed in 17.5% of patients (n = 48). At 24 M, 48 patients met the metabolic syndrome (MetS) criteria and there was an increase in patients with a BMI of &gt;25 kg\/m2 (p &lt; 0.001). At B and 24 M, a BMI of &gt;25 kg\/m2 is a risk factor for significant fibrosis or steatosis at 24 M (p &lt; 0.05) and progression on LSM (p &lt; 0.001), as well as MetS at B and 24 M (OR 4.1 IC (1.4\u201311.7), p = 0.008; and OR 5.4 IC (1.9\u201315.4), p = 0.001, respectively). Regarding the correlation between LSM and the liver biopsy, we found that only six out of 13 patients had a matching LSM and biopsy. We found a statistically significant decrease in LOXL2 levels at 24 M with respect to B (p &lt; 0.001) with higher serological value in patients with elastography of &gt;9 kPa vs. &lt;9 kPa (p = 0.046). Conclusion: Regression of LSM was reached in 82% of patients. Downregulated LOXL2 was demonstrated post-SVR, with overexpression in cirrhotic patients being a potential therapy goal in selected patients.<\/jats:p>","DOI":"10.3390\/jcm8081242","type":"journal-article","created":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T06:10:14Z","timestamp":1566195014000},"page":"1242","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Changes in Circulating Lysyl Oxidase-Like-2 (LOXL2) Levels, HOMA, and Fibrosis after Sustained Virological Response by Direct Antiviral Therapy"],"prefix":"10.3390","volume":"8","author":[{"given":"Angela","family":"Puente","sequence":"first","affiliation":[{"name":"Digestive Disease Department, Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Ignacio","family":"Fortea","sequence":"additional","affiliation":[{"name":"Digestive Disease Department, Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Posadas","sequence":"additional","affiliation":[{"name":"Medicine and Psychiatry Department, Cantabria University, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7372-5825","authenticated-orcid":false,"given":"Agustin","family":"Garcia Blanco","sequence":"additional","affiliation":[{"name":"Digestive Disease Department, Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Rasines","sequence":"additional","affiliation":[{"name":"Digestive Disease Department, Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0012-484X","authenticated-orcid":false,"given":"Joaquin","family":"Cabezas","sequence":"additional","affiliation":[{"name":"Digestive Disease Department, Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Arias Loste","sequence":"additional","affiliation":[{"name":"Digestive Disease Department, Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"Llerena","sequence":"additional","affiliation":[{"name":"Digestive Disease Department, Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Iruzubieta","sequence":"additional","affiliation":[{"name":"Digestive Disease Department, Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"F\u00e1brega","sequence":"additional","affiliation":[{"name":"Digestive Disease Department, Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8248-0172","authenticated-orcid":false,"given":"Javier","family":"Crespo","sequence":"additional","affiliation":[{"name":"Digestive Disease Department, Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain"},{"name":"Medicine and Psychiatry Department, Cantabria University, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,8,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2018). 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