Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most globally prevalent chronic liver disorder. Thus, this study aimed to evaluate the association of serum endocan and endoglin levels with fibrosis severity in patients with MASLD. In the study, between December 2023 and November 2024, 58 MASLD patients and 30 healthy controls were enrolled; sample size was based on a power analysis. Vibration-controlled transient elastography, reporting controlled attenuation parameter, and liver stiffness in kilopascals was used to quantify hepatic steatosis and fibrosis, and serum endocan and endoglin levels were measured. Comparisons were made between the MASLD and control groups, and within the MASLD group between patients with advanced-stage fibrosis versus those with lower-stage fibrosis. Discriminative ability of the biomarkers was evaluated by receiver operating characteristic (ROC) analysis. Independent associations between serum biomarkers and kilopascals values in the patient group were assessed by regression analysis. Serum endocan and endoglin were significantly elevated in the MASLD group compared with controls. In the MASLD group, patients with advanced fibrosis exhibited higher endocan and endoglin levels than those with lower-stage fibrosis. In ROC analysis for discriminating advanced fibrosis, endoglin demonstrated strong discriminative ability and endocan exhibited good accuracy for fibrosis assessment. Multivariate regression analysis revealed that log-transformed kilopascals values were independently associated with serum endocan and endoglin. Endoglin and endocan are promising, accessible noninvasive biomarkers that may support fibrosis triage and referral decisions in general internal medicine for MASLD. Prospective validation is warranted.

The Model for End-stage Liver Disease Sodium (MELD-Na) score predicts mortality in liver transplant candidates. MELD 3.0 has been proposed as an improved model for estimating mortality risk. This study evaluated MELD 3.0’s predictive accuracy for short-term mortality among Turkish liver transplant candidates and compared its performance with MELD and MELD-Na scores. Patients listed both for deceased donor transplants and living donor transplants were analyzed in the study. The discriminative abilities of MELD, MELD-Na, and MELD 3.0 scores were assessed using the area under the receiver operating characteristic curve (AUROC). Comparisons between AUROC values used the DeLong test. The most predictive cutoff for MELD 3.0 was determined using the Youden index. Transplant-free survival was analyzed using the Kaplan–Meier method, with survival curves compared using the log-rank test. A total of 1689 patients were included in this nationwide, multicenter study. Hepatitis B was the leading cause of cirrhosis (29%, n=491), followed by metabolic dysfunction–associated steatohepatitis (20%, n=335). For 3-month mortality, MELD 3.0 had the highest AUROC (0.753), followed by MELD-Na (0.747) and MELD (0.725). The most predictive cutoff values were 18 for MELD and 21 for MELD-Na and MELD 3.0. Both MELD-Na and MELD 3.0 outperformed MELD ( p <0.001), but showed no significant difference between them ( p =0.17). MELD 3.0 and MELD-Na demonstrated superior performance to MELD in predicting 3-month mortality among Turkish liver transplant candidates, though their predictive accuracy was comparable. Further refinements are needed to enhance MELD 3.0’s clinical utility.