Estimation the Change in Liver Fibrosis Stage with Serial Measurement of Wisteria Floribunda Agglutinin-Positive Mac-2 Binding Protein in Metabolic Dysfunction-Associated Steatotic Liver Disease Patients

Assessment of liver fibrosis stage is important in the management of patients with metabolic dysfunction-associated steatotic liver disease (MASLD). However, non-invasive methods to determine the changes in liver fibrosis stage are unknown. We investigated whether Wisteria floribunda agglutinin-positive human Mac-2 binding protein (WFA⁺-M2BP), a serum fibrosis marker, can evaluate the changes in liver fibrosis stage. We observed the course of liver fibrosis stage and five serum fibrosis markers of 196 MASLD patients who had a paired biopsy performed. The changes in fibrosis markers, including WFA⁺-M2BP, were compared according to the changes in fibrosis stage. Factors associated with improvement of fibrosis stage were examined in a multivariate analysis. The changes in WFA⁺-M2BP (ΔWFA⁺-M2BP) were significantly correlated with changes in fibrosis stage (<i>p</i> < 0.01). The median of ΔWFA⁺-M2BP was -0.21, -0.08, -0.04, and 0.19 in 2 fibrosis stage regression group, 1 fibrosis stage regression group, fibrosis stage unchanged group, and fibrosis stage progression group, respectively (<i>p</i> < 0.01). However, other non-invasive markers did not reflect changes in fibrosis. ΔWFA⁺-M2BP was a significant factor for the regression of liver fibrosis stage in multivariate analysis (odds ratio: 3.54, 95% confidence interval: 1.55-8.12, <i>p</i> < 0.01). Time-course changes in WFA⁺-M2BP levels indicate the changes in liver fibrosis.