Metabolic dysfunction‑associated steatotic liver disease and metabolic abnormalities are associated with age and serum des‑acyl ghrelin among apparently healthy females: Findings from a whole gastroenteropancreatic hormones survey with path analysis

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver condition associated with metabolic disturbances, with high incidence in Asian regions. Numerous patients with MASLD, particularly females, are neither obese nor overweight. Although gastroenteropancreatic hormones (GEPHs) are key in metabolic regulation, current understanding is largely limited to a subset of these hormones. The present study aims to identify key factors influencing MASLD and associated metabolic abnormalities among female patients. GEPHs were assessed in 139 adult female volunteers. Using separate forward-selected regression to screen 12 candidate factors, the present study identified age and serum des-acyl ghrelin as the primary determinants of MASLD development. Pathway analysis validated their mechanistic roles. Predictive classification based on Mahalanobis distance using these two factors effectively stratified at-risk individuals. Body mass index and waist circumference were notable mediators. This cross-sectional study identified significant correlations between age, serum des-acyl ghrelin and metabolic complications, including MASLD, in adult females. Monitoring serum des-acyl ghrelin levels may offer predictive insights into metabolic risks in preventive medicine. However, to determine the accuracy and reliability of these predictions, future longitudinal studies are needed to determine the association between serum des-acyl ghrelin levels and the progression of metabolic disease.