Short- and Medium-Chain Fatty Acid Profiles in Biopsy-Proven Metabolic Dysfunction-Associated Steatotic Liver Disease: A Cross-Sectional Study

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common metabolic liver disease with increasing prevalence worldwide. Increasing evidence suggests that short-chain fatty acids (SCFAs) play an important role in MASLD. Medium-chain fatty acids (MCFAs), although less studied, may also contribute to MASLD pathogenesis. The aim of this study was to evaluate plasma SCFA and MCFA profiles across the MASLD histological spectrum and their associations with clinical, biochemical, and histopathological features of disease severity.

Methods

We included 115 adults with obesity undergoing bariatric surgery. Intraoperative liver biopsies were assessed using the Steatosis, Activity, Fibrosis (SAF) score. Participants were classified as no MASLD (n = 26), metabolic dysfunction-associated steatotic liver (MASL; n = 42), or metabolic dysfunction-associated steatohepatitis (MASH; n = 47). Six SCFAs and two MCFAs were quantified in plasma by liquid chromatography–mass spectrometry.