SynthesisInternational journal of molecular sciences2026
Circulating Adipokines in Alcohol-Related Liver Disease and MetALD: A Systematic Review and Structured Narrative Synthesis.
Synthesis in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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6 authors.
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Abstract
Alcohol-related liver disease (ALD) and metabolic dysfunction and alcohol-related liver disease (MetALD) are increasingly recognised as biologically heterogeneous conditions, but circulating novel adipokines have not been systematically synthesised in this setting. We searched PubMed/MEDLINE, Embase, Web of Science, Scopus and Cochrane CENTRAL from inception to 31 December 2025 for studies measuring chemerin, visfatin/nicotinamide phosphoribosyltransferase (NAMPT), vaspin, omentin-1 or retinol-binding protein 4 (RBP-4) in adults with ALD or MetALD; data were synthesised narratively using Synthesis Without Meta-Analysis (SWiM). Grey literature and non-English databases were not searched, which may have led to incomplete retrieval of small single-centre studies. Five studies were included. Direct ALD evidence came mainly from three cross-sectional alcoholic cirrhosis cohorts, while one population cohort linked baseline RBP-4 to incident MetALD/ALD. RBP-4 showed a phase-dependent pattern, increasing before incident MetALD/ALD but decreasing in established cirrhosis with impaired synthetic function. Chemerin was reduced, omentin-1 was markedly elevated, vaspin was nonspecific and historical visfatin/NAMPT assays were difficult to interpret. Current evidence supports a hypothesis-generating three-axis framework: hepatic source failure, impaired hepatic clearance/portal-systemic shunting and alcohol-driven adipose-liver inflammation. The available evidence chiefly reflects chronic alcohol-related cirrhosis together with limited incident MetALD/ALD risk data, rather than the full ALD/MetALD spectrum. Prospective MetALD-stratified cohorts with isoform-specific assays and objective alcohol biomarkers are required.
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