23 DOI: https://doi.org/10.1016/j.jgeb.2026.100733 English eng Ghada M. Salum Contributor <div class="abstract author" id="as0005" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0010" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Background</h3><div class="u-margin-s-bottom" id="sp0050" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">Matrix metalloproteinases (MMP-9) play a vital role in extracellular matrix remodeling in metabolic-associated steatotic liver disease (MASLD) and cardiovascular diseases such as atherosclerosis. This study assesses MMP-9 levels in conjunction with non-invasive scoring systems (BAAT, BARD, FIB-4, NAFLD Fibrosis Score, and the ALT/AST ratio) aiming to enhance early diagnosis and disease monitoring.</div></div><div class="abstract author" id="as0010" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0015" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Methods</h3><div class="u-margin-s-bottom" id="sp0055" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">The study included 88 participants: 25 normal individuals and 63 MASLD patients with varying grades (S1 to S3). Atherosclerosis was staged into four stages. The current study measured MMP-9 concentrations in MASLD patients and analyzed their correlation with MASLD grades, atherosclerosis stages, and non-invasive scoring systems (BAAT, BARD, FIB-4, NAFLD Fibrosis Score, and the ALT/AST ratio).</div></div><div class="abstract author" id="as0015" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0020" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Results</h3><div class="u-margin-s-bottom" id="sp0060" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">Elevated MMP-9 levels were significantly associated with S2 and S3 MASLD grades (<em style="margin: 0px; padding: 0px;">p</em> = 0.02, 0.04; respectively) compared to controls and atherosclerosis progression (<em style="margin: 0px; padding: 0px;">p</em> = 0.05). Although ROC analysis showed AUC = 0.90 for discriminating advanced plaque, only two patients in our cohort had advanced plaque, which limits the generalizability of this result. Spearman correlation analysis reveals a positive correlation between MMP-9 concentration and the progression of MASLD (<em style="margin: 0px; padding: 0px;">r</em> = 0.4, <em style="margin: 0px; padding: 0px;">p</em> ≤ 0.01), atherosclerosis (<em style="margin: 0px; padding: 0px;">r</em> = 0.3, <em style="margin: 0px; padding: 0px;">p</em> ≤ 0.05), and BAAT (<em style="margin: 0px; padding: 0px;">r</em> = 0.254, p ≤ 0.05). BAAT score also correlated with BARD and FIB-4 scores ((r = 0.3, p ≤ 0.05, and <em style="margin: 0px; padding: 0px;">r</em> = 0.5 p ≤ 0.01; respectively). The highest correlation was seen between NAFLD Fibrosis score and FIB-4 (<em style="margin: 0px; padding: 0px;">r</em> = 0.7, p ≤ 0.01).</div></div><div class="abstract author" id="as0020" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0025" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Conclusion</h3><div class="u-margin-s-bottom" id="sp0065" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">MMP-9 is a probable biomarker for assessing MASLD and may improve cardiovascular risk evaluation, especially when combined with BAAT score.</div></div> Elsevier September 2026 pdf Journal of Genetic Engineering and Biotechnology MMP-9 and non-invasive markers in evaluating MASLD and atherosclerosis mixed material Elsevier