Assessment of prognostic factors and circulating biochemical markers in patients with liver disorders

The global burden of non-alcoholic fatty liver disease (NAFLD) necessitates reliable biomarkers for early detection, particularly in high-risk South Asian populations. This cross-sectional study evaluated oxidative stress markers, dietary patterns, and fibrosis indices in 100 biopsy-proven NAFLD patients (50 male, 50 female; age 35–60 years; BMI 25–40 kg/m²) and 50 matched controls from Sargodha, Pakistan. Comprehensive profiling revealed significantly elevated oxidative stress in NAFLD patients, with malondialdehyde (MDA) levels 61.2% higher (214.1 ± 12.3 vs. 132.9 ± 11.2 nmol/gHb, p < 0.001) and glutathione (GSH) 50.5% lower (35.4 ± 2.1 vs. 71.6 ± 1.9 mg/gHb, p < 0.001) than controls. Fibrosis-4 (FIB-4) scores correlated strongly with oxidative markers (r = 0.72, p < 0.01) and Western dietary patterns (r = 0.65, p < 0.05). Hypomagnesemia (1.65 ± 0.06 vs. 2.3 ± 0.07 mg/dL, p < 0.04) and elevated TNF-α (p < 0.01) were prominent metabolic disturbances. Dietary analysis identified three patterns, with meat-based diets associated with the highest oxidative stress index (OSI: 37.3 vs. 17.5 in vegetarians, p < 0.01). These findings propose a cost-effective prognostic panel combining oxidative stress markers (MDA, GSH), fibrosis indices (FIB-4), and dietary assessment for NAFLD management in resource-limited settings. However, larger multicenter studies are needed to validate these associations and explore causal mechanisms