Serum insulin-like growth factor binding protein 2 is associated with hepatic steatosis in adults with metabolic dysfunction-associated steatotic liver disease.

Objective: To evaluate the association between serum insulin-like growth factor binding protein 2 (IGFBP2) and the degree of hepatic steatosis in patients with MASLD. Methods: A total of 347 patients with metabolic dysfunction-associated steatotic liver disease (MASLD) were enrolled, adhering to the inclusion criteria. The controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were measured by FibroScan, while serum IGFBP2 levels were quantified by ELISA. Hepatic IGFBP2 mRNA expression data were obtained from the Gene Expression Omnibus database (GEO database). Levels of serum IGFBP2 and hepatic IGFBP2 mRNA between healthy controls and MASLD patients were separately compared. Correlation analyses were performed to evaluate the relationships between CAP and IGFBP2. Results: Both the serum IGFBP2 levels and the hepatic IGFBP2 mRNA expression were significantly higher in patients with MASLD compared with healthy individuals. In patients with MASLD, the serum IGFBP2 level showed an inverse correlation with CAP values (r = -0.133, P < 0.05) and was identified as an independent determinant of hepatic steatosis (β = -0.104, P < 0.05), while no significant association was observed between LSM and IGFBP2 (P > 0.05). Conclusion: In patients with MASLD, IGFBP2 may exert a protective effect against hepatic steatosis progression but appears to play a negligible role in fibrogenesis.