Evidence map›Paper›PMID 42337268›Full record

ArticleNature communications2026

The metabolic vulnerability index predicts outcomes in patients with metabolic dysfunction associated steatotic liver disease.

Mohammad S Siddiqui, Mark L Van Natta, Margery A Connelly, Jeanne Clark, Brent A Neuschwander-Tetri, Anna Mae Diehl, Srinivasan Dasarathy, Rohit Loomba, Naga Chalasani, Kris V Kowdley and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Mohammad S Siddiqui *Virginia Commonwealth University School of Medicine, Richmond, VA, USA.ORCID 0000-0001-7392-7489
Mark L Van Natta *Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Margery A ConnellyLabcorp, Morrisville, NC, USA.ORCID 0000-0002-3917-592X
Jeanne ClarkBloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Brent A Neuschwander-TetriSaint Louis University, St. Louis, MO, USA.ORCID 0000-0002-8520-7398
Anna Mae DiehlDuke University, Durham, NC, USA.ORCID 0000-0003-1859-089X
Srinivasan DasarathyCleveland Clinic, Cleveland, OH, USA.ORCID 0000-0003-1774-0104
Rohit LoombaUniversity of California San Diego School of Medicine, San Diego, CA, USA.
Naga ChalasaniIndiana University School of Medicine, Indianapolis, IN, USA.
Kris V KowdleyLiver Institute Northwest, Seattle, WA, USA.
Bilal HameedUniversity of California San Francisco School of Medicine, San Francisco, CA, USA.
Laura A WilsonBloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Katherine P YatesBloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.ORCID 0000-0001-6138-2194
Patricia BeltBloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
David E KleinerLaboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.ORCID 0000-0003-3442-4453
Cynthia BehlingUniversity of California San Diego School of Medicine, San Diego, CA, USA.
James TonasciaBloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Arun J SanyalVirginia Commonwealth University School of Medicine, Richmond, VA, USA. arun.sanyal@vcuhealth.org.ORCID 0000-0001-8682-5748

Funding

Pediatric Trials in Non-Alcoholic Steatohepatitis (NASH)U01DK061734 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI ROHIT LOOMBA · 2002 to 2026
$24.4M
Continuation of the Non-Alcoholic Steatohepatitis Clinical Research Network (NASHU01DK061730 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI TONASCIA, JAMES A · 2002 to 2018
$23.2M
Non Alcoholic Steatohepatitis Clinical Research NetworkU01DK061732 · NIDDK · CLEVELAND CLINIC LERNER COM-CWRU · PI Srinivasan Dasarathy · 2002 to 2026
$12.2M
The Saint Louis University Component of the NASH CRNU01DK061718 · NIDDK · SAINT LOUIS UNIVERSITY · PI BRENT A NEUSCHWANDER-TETRI · 2002 to 2026
$12.0M
VEDS Year2-Continuation of the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) Data Coordinating CenterU24DK061730 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI JEANNE M CLARK, David M Shade · 2019 to 2026
$11.3M
Nonalcoholic Steatohepatittis Clinical Research Network (NASH CRN)U01DK061731 · NIDDK · VIRGINIA COMMONWEALTH UNIVERSITY · PI ARUN J SANYAL · 2002 to 2026
$11.2M
Pathogenesis, prognosis, and treatment of NAFLD patientsU01DK061713 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI ANNA MAE ELIZABETH DIEHL · 2002 to 2026
$10.3M
Collaborative Clinical Research on Non Alcoholic StratohepatitisU01DK061737 · NIDDK · INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS · PI NAGA P CHALASANI · 2002 to 2026
$10.2M
Clinical Research Network in Non-Alcoholic SteatohepatitisU01DK061728 · NIDDK · UNIVERSITY OF WASHINGTON · PI KRIS KOWDLEY · 2002 to 2026
$9.0M
Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN)U01DK061738 · NIDDK · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Norah A. Terrault · 2002 to 2026
$8.9M
NIDDK NIH HHS U01DK061713NIDDK NIH HHS U01DK061718NIDDK NIH HHS U01DK061728NIDDK NIH HHS U01DK061730NIDDK NIH HHS U01DK061731NIDDK NIH HHS U01DK061732NIDDK NIH HHS U01DK061734NIDDK NIH HHS U01DK061737NIDDK NIH HHS U01DK061738NIDDK NIH HHS U24DK061730
6 · The paper itself

Abstract

We evaluated the prognostic performance of the metabolic vulnerability index (MVX), reflective of inflammation and amino acid dysmetabolism, in a cohort (n = 1613) with the full histological spectrum of MASLD. Over a median follow up of 4 years, MVX predicts all-cause mortality (H.R. 2.7 (95% CI = 2.1-3.5) for every 10-point increment; p < 0.001), liver-related mortality (H.R. 5.1 (95% CI = 2.8-9.1); p < 0.001), hepatic decompensation (H.R. 2.5 (95% CI = 1.8-3.4); p < 0.001), a rise in model for end-stage liver disease (MELD) score to ≥ 15 (H.R. 1.8 (1.4-2.2); p < 0.001) and a decline in eGFR ≥ 40% (H.R. 1.5 (95% CI = 1.2-1.8); p < 0.001). A combination of fibrosis stage and MVX is superior to fibrosis stage alone for prediction of all-cause mortality (AUROC 0.79 vs 0.72, p = 0.01), liver-related mortality (0.95 vs 0.84, p = 0.002) hepatic decompensation (0.88 vs 0.86, p = 0.01) and hepatocellular cancer (0.84 vs 0.78, p = 0.001). These data support further development of MVX as a prognostic biomarker in MASLD.

Indexed as

Non-alcoholic Fatty Liver DiseaseAdultAgedBiomarkersEnd Stage Liver DiseaseFemaleHumansLiverLiver CirrhosisLiver NeoplasmsMaleMiddle AgedPrognosisSeverity of Illness IndexBiomarkers

Identifiers

PMID42337268
PMCPMC13291223

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.