Mac-2-Binding Protein Glycosylation Isomer as a Biomarker of Non Alcoholic Fatty Liver Disease in Type 2 Diabetic Patients

Alazizi, Nashwa Mohammad; Elhady Ahmad, Hoda Abdelaziz; Ragab El-Sayed, Mohamed Magdi; Fikry Abdelrahman, Abeer Abdalla

doi:10.21608/zumj.2025.363988.3856

Mac-2-Binding Protein Glycosylation Isomer as a Biomarker of Non Alcoholic Fatty Liver Disease in Type 2 Diabetic Patients

Document Type : Original Article

Authors

¹ Professor of Clinical Pathology department, Faculty of Medicine, Zagazig University, Egypt

² Professor of Internal Medicine department, Faculty of Medicine, Zagazig University, Egypt

³ Clinical pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

⁴ Assistant Professor of Clinical Pathology department, Faculty of Medicine, Zagazig University, Egypt

10.21608/zumj.2025.363988.3856

Abstract

Background: The rising incidence of diabetes also contributes to the rise in nonalcoholic fatty liver disease (NAFLD). There is mounting evidence that the levels of the serum Mac-2-binding protein glycosylation isomer (M2BPGi) reflect the build-up of fat in the liver. This study assessed the clinical utility of blood M2BPGi levels in patients with type 2 diabetes who also had non-alcoholic fatty liver disease (NAFLD). Methods: This case-control study included 23 subjects who serve as apparently healthy control, 23 type 2 diabetic patients without NAFLD, and 23 type 2 diabetic patients with NAFLD. Fatty liver was diagnosed by abdominal ultrasound scan. Serum M2BPGi level was determined by ELISA. Results: M2BPGi was significantly higher in diabetic group without NAFLD when compared to controls and in diabetic group with NAFLD when compared to diabetic patients without NAFLD and controls. A significant positive correlation was detected between M2BPGi and ALT, HbA1c, FLI score and ACR in diabetic patients with NAFLD. M2BPGi showed an area under the curve (AUC) of 0.886, 86.9% sensitivity, and 78.2% specificity for diagnosing of NAFLD in diabetic patients, according to receiver operating characteristic (ROC) curve analysis. In combination with FLI, the sensitivity was 95.8% and specificity was 100%. Conclusions: M2BPGi might act as a non-invasive marker for nonalcoholic fatty liver either alone or in combination with FLI. Also, it was correlated with steatosis grades and associated with microalbuminuria.

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