# Interleukin-38: A Candidate Biomarker for Disease Severity in Advanced Steatotic Liver Disease

## TL;DR

This study suggests that Interleukin-38 (IL-38) could be a useful biomarker for predicting the severity of advanced fatty liver disease.

## Contribution

The study identifies IL-38 as a novel biomarker for assessing disease severity in steatotic liver disease.

## Key findings

- IL-38 levels are significantly higher in decompensated steatotic liver disease patients compared to compensated patients.
- IL-38 correlates strongly with MELD scores and liver function markers like bilirubin and AST.
- A model combining MELD and IL-38 achieves high diagnostic accuracy (AUC ≈ 0.92).

## Abstract

Background: Interleukin-38 (IL-38) is an anti-inflammatory IL-1—family cytokine implicated in limiting tissue injury by its anti-inflammatory character. We evaluated the diagnostic discrimination and prognostic relevance in steatotic liver disease (SLD). Methods: We conducted a prospective, monocentric cohort analysis of 184 patients with SLD (n = 176) and healthy controls (n = 8). We tested group differences using Mann–Whitney U or Kruskal–Wallis; determined diagnostic quality using ROC curves. Logistic regression was used to assess the relationship with decompensation. Associations with MELD and routine laboratory parameters were modeled using Spearman correlation and linear regression. We analyzed survival using Kaplan–Meier and Cox regression. Findings: IL-38 concentrations were found to be higher in decompensated (n = 94) than in compensated patients (n = 82) (p < 0.001). MELD was positively associated with IL-38 (p < 0.001; 95% CI 0.057–0.120). This corresponds to a 9.2% increase in IL-38 per 1-point increase in MELD (95% CI 5.9–12.7%). IL-38 correlated positively with the MELD score (p < 0.001) and with bilirubin/AST/LDH. In the combination model (MELD + IL-38 ± CRP), a very good AUC ≈ 0.92 was achieved. Conclusion: IL-38 reflects the severity of steatotic liver disease and is therefore a potentially predictive biomarker for early risk stratification and therapy monitoring.