The correlation of Angiopoietin-like protein 7 and ferroptosis-related proteins in patients with metabolic associated fatty liver disease

Objective The prevalence of metabolic associated fatty liver disease (MAFLD) was increased globally, and data has indicated that ferroptosis participates in the pathogenesis of MAFLD. Angiopoietin-like protein 7 (Angptl 7) is a novel secretory glycoprotein, participating in pathogenesis of many metabolic disorders. However, the role of Angptl 7 playing in MAFLD has been little investigated. Methods A total of 194 participants were enrolled in this study, in which there were 104 MAFLD patients (MAFLD), and 90 healthy controls (CON). Baseline characteristics and serum biochemical parameters were collected. Serum levels of Angptl 7, inflammatory factors and ferroptosis- related proteins were measured by enzyme-linked immunosorbent assay (ELISA). Liver biopsy tissues were obtained from 6 nonalcoholic steatohepatitis participants and the trimmed liver tissues were from 5 healthy liver transplant donors. H&E, Masson, Perls staining and immunohistochemical staining were performed. Results Compared to healthy controls, BMI, SBP and DBP were significantly increased, and serum ALT, AST, TC, TG, LDL-C, GLU, HbA1c, INS, Hcy and UA levels were all significantly increased, while HDL-C was significantly decreased in MAFLD patients (MAFLD vs. CON, P < 0.05 or P < 0.001). Serum Angptl 7, TNF-α, IL-6, ACSL4, Keap-1, HO-1 and Ferritin were significantly increased, while IL-10, GPX4 and Nrf2 were decreased in MAFLD patients when compared to CON group (MAFLD vs. CON, P all < 0.001). Immunohistochemical staining showed that the expression of Angptl 7, Keap-1 and HO-1 were significantly increased, while Nrf2 was significantly decreased in liver tissue from MAFLD group when compared to CON (MAFLD vs. CON, P all < 0.05). ROC analysis showed that Angptl 7 could be as a potential biomarker for diagnosis of MAFLD and the cut-off level was 9.75ng/mL. Conclusion Angptl 7 might participate in the pathogenesis of MAFLD and serum Angptl 7 might be predictive for diagnosis of MAFLD.