Lactate Dehydrogenase Levels Predict Severity of MAFLD and Metabolic Syndrome: Study Finds

"Patients with metabolic-associated steatohepatitis (MASH) also showed higher LDH levels. LDH levels were positively linked to the severity of MAFLD, including fibrosis grades ≥1, ≥2, and ≥3, and at-risk MASH," the researchers reported.

Metabolism-associated fatty liver disease, affecting most obese patients, is linked to metabolic syndromes like type 2 diabetes, obesity, liver damage, and severe liver conditions. The new definition of MAFLD underscores the role of metabolic disorders in its pathogenesis. Liang Yu, from The Second Affiliated Hospital of Anhui Medical University in Hefei, People’s Republic of China, and colleagues aimed to evaluate the relationship between lactate dehydrogenase levels and the severity of MetS and MAFLD, as well as the potential diagnostic role of LDH in identifying individuals at risk for metabolic associated steatohepatitis.

For this purpose, the researchers conducted a cross-sectional, real-world retrospective study, enrolling 1,118 obese patients from the Department of Bariatric Surgery at the Second Affiliated Hospital of Anhui Medical University between January 1, 2018, and December 31, 2021. Of these, 855 patients were included in the study cohort. MAFLD was defined based on the presence or absence of fatty liver disease, confirmed by histologic liver biopsy, postoperative pathology slides, or hematology, and meeting one of the following conditions: overweight or obesity, type 2 diabetes mellitus (T2DM), or metabolic dysfunction.

Serum LDH activity levels were measured in 885 patients, and logistic regression was employed to analyze the association between LDH levels, metabolic syndrome, and the severity of MAFLD.

Key Findings:

• In the study cohort of 855 obese patients, 70.6% were diagnosed with metabolic syndrome.
• Patients with MetS had significantly higher serum LDH levels (214.1) than those without MetS (188.7).
• Serum LDH levels were notably higher in patients with hypertension, central obesity, diabetes or hyperglycemia, elevated triglycerides, or low levels of high-density lipoprotein (HDL).
• LDH concentrations increased progressively with total number of MetS components in each patient.
• Subjects with metabolic-associated steatohepatitis (MASH) had significantly higher LDH levels than patients in the less severe non-MASH groups, including normal liver, simple fatty steatosis, and B.MASH.
• Logistic regression analysis revealed a significant positive correlation between LDH levels and MAFLD, B.MASH, MASH, at-risk MASH, and various fibrosis grades (≥1, ≥2, ≥3).

"The study is the first clinical investigation to confirm that serum LDH levels are significantly elevated in patients with MetS and that LDH is an independent predictor of MetS presence in the study population. Based on these findings, serum LDH shows promise as a potential biomarker for MetS, though additional studies are required to establish its clinical utility," the researchers concluded.

Reference:

Yu L, Bao S, Zhu F, Xu Y, Zu F, Liu Y, Jiang R, Chen S, Chen W. Serum Lactate Dehydrogenase Is a Novel Predictor for the Severity in the Patients With MAFLD: A Cross-Sectional Study in Hefei, China. Diabetes Metab Syndr Obes. 2025;18:345-361. https://doi.org/10.2147/DMSO.S492153