{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T16:16:39Z","timestamp":1768320999538,"version":"3.49.0"},"reference-count":24,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Background: Metabolic syndrome (MetS) comprises interrelated metabolic abnormalities that collectively confer increased risk of cardiovascular disease and hepatic morbidity. The MAF-5 score is a non-invasive prognostic marker of liver fibrosis and mortality, while Cystatin C (CysC) is a sensitive indicator of renal function that also reflects inflammation, atherosclerosis, and metabolic dysfunction. Although both MetS and CysC have been widely studied, their potential interplay via MAF-5 remains unclear. We aimed to investigate the relationship between MAF-5 scores and CysC levels in MetS patients for the first time. Materials and Methods: Adults (\u226518 years) with MetS were included in this study. MAF-5 scores (based on waist circumference, BMI, diabetes status, AST, and platelet count) and CysC levels were recorded. The MAF-5\u2013CysC relationship was assessed via Pearson correlation. Participants were grouped into MAF-5 quartiles, and continuous variables were compared using ANOVA with Bonferroni-corrected pairwise tests. Results: We included 347 MetS patients (54.8% female, median age 54 years). The median MAF-5 score was 1.25, and MAF-5 correlated positively with CysC (r = 0.357, p &lt; 0.001). CysC levels differed significantly across MAF-5 quartiles (Q1 = 0.96, Q2 = 0.99, Q3 = 1.06, Q4 = 1.09; p &lt; 0.001), with Q4 showing higher values than Q1 and Q2. Conclusions: A significant correlation was found between MAF-5 scores and CysC in patients with MetS. CysC levels differed significantly across MAF-5 quartiles, suggesting a potential link between systemic inflammation, liver fibrosis, and CysC. These results highlight shared inflammatory and fibrotic pathways, underlying metabolic dysfunction. Clinically, combined assessment of MAF-5 and CysC may improve risk stratification, identifying patients at higher risk for hepatic fibrosis and adverse outcomes.<\/jats:p>","DOI":"10.3390\/metabo16010071","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T10:13:51Z","timestamp":1768299231000},"page":"71","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cystatin C Mirrors Fibrosis Burden in Metabolic Syndrome: Insights from the Metabolic Dysfunction-Associated Fibrosis-5 Score"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5050-531X","authenticated-orcid":false,"given":"Musa","family":"Salmano\u011flu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Sultan 2. Abd\u00fclhamid Han Training and Research Hospital, University of Health Sciences, Selimiye, T\u0131bbiye Cd, 34668 \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7290-4680","authenticated-orcid":false,"given":"Sinan","family":"Kazan","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Afyonkarahisar Health Sciences University, Battalgazi, Ahmet Necdet Sezer Kamp\u00fcs\u00fc, 03204 Afyonkarahisar, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2404-8784","authenticated-orcid":false,"given":"Elif","family":"Y\u0131ld\u0131r\u0131m Ayaz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Sultan 2. Abd\u00fclhamid Han Training and Research Hospital, University of Health Sciences, Selimiye, T\u0131bbiye Cd, 34668 \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00fcleyman","family":"K\u0131l\u0131\u00e7","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Sultan 2. Abd\u00fclhamid Han Training and Research Hospital, University of Health Sciences, Selimiye, T\u0131bbiye Cd, 34668 \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elif","family":"Kazan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Afyonkarahisar Health Sciences University, Battalgazi, Ahmet Necdet Sezer Kamp\u00fcs\u00fc, 03204 Afyonkarahisar, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sena","family":"Ulu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Sultan 2. Abd\u00fclhamid Han Training and Research Hospital, University of Health Sciences, Selimiye, T\u0131bbiye Cd, 34668 \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2486","DOI":"10.1001\/jama.285.19.2486","article-title":"Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III)","volume":"285","author":"Cleeman","year":"2001","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/S0140-6736(05)67402-8","article-title":"The metabolic syndrome\u2014A new worldwide definition","volume":"366","author":"Alberti","year":"2005","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1161\/CIRCULATIONAHA.105.169404","article-title":"Diagnosis and Management of the Metabolic Syndrome","volume":"112","author":"Grundy","year":"2005","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3160","DOI":"10.2337\/diacare.26.11.3160","article-title":"Follow-up report on the diagnosis of diabetes mellitus","volume":"26","author":"Genuth","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1007\/s10620-024-08354-4","article-title":"Effect of Concurrent Metabolic Dysfunction-Associated Steatotic Liver Disease on Serial Non-invasive Fibrosis Markers in Chronic Hepatitis B","volume":"69","author":"Con","year":"2024","journal-title":"Dig. 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