BACKGROUND: Vibrational and chiroptical spectroscopy of blood plasma is an advanced experimental diagnostic approach that allows the identification of disease-specific molecular patterns. This study aimed to test its potential to distinguish between different stages of metabolic dysfunction-associated steatotic liver disease (MASLD) including liver fibrosis. METHODS: We analyzed blood plasma samples from 29 patients with metabolic dysfunction-associated steatohepatitis (MASH) and 24 MASLD patients with simple steatosis using Fourier-transform infrared (FTIR) spectroscopy, Raman spectroscopy and electronic circular dichroism (ECD) spectroscopy to distinguish: (i) MASH; (ii) MASH with moderate to advanced fibrosis; and (iii) overall fibrosis. RESULTS: FTIR spectroscopy distinguished MASH from simple steatosis with a sensitivity of 73% and a specificity of 92%, with an area under the receiver operating characteristic curve (AUROC) of 0.92, p < 0.001. In addition, FTIR spectroscopy identified MASH with moderate to advanced fibrosis (F2-3) from MASH/steatosis with no to mild fibrosis (F0-1) with a sensitivity of 87% and specificity of 78% (AUROC 0.91, p < 0.001). Furthermore, regardless of the MASH/steatosis diagnosis, fibrosis (F1-3) was distinguished from F0 by the combination of data from the three spectroscopic methods with a sensitivity of 79% and a specificity of 88% (AUROC 0.91, p < 0.001). Both FTIR and Raman spectroscopy alone discriminated all target groups with an AUROC > 0.82. CONCLUSIONS: This pilot study revealed the potential of blood plasma spectroscopy to identify and differentiate patients with various stages of MASLD.

• Keywords
• Chiroptical spectroscopy, Electronic circular dichroism spectroscopy (ECD), Fourier-transform infrared (FTIR) spectroscopy, Liver fibrosis, Metabolic dysfunction-associated steatohepatitis (MASH), Metabolic dysfunction-associated steatotic liver disease (MASLD), Noninvasive diagnostics, Raman spectroscopy, Simple steatosis, Vibrational spectroscopy,
• MeSH
• Circular Dichroism MeSH
• Diagnosis, Differential MeSH
• Adult MeSH
• Liver Cirrhosis blood   diagnosis   MeSH
• Middle Aged MeSH
• Humans MeSH
• Metabolic Diseases * blood   complications   diagnosis   MeSH
• Spectrum Analysis, Raman MeSH
• ROC Curve MeSH
• Aged MeSH
• Spectroscopy, Fourier Transform Infrared MeSH
• Fatty Liver * blood   diagnosis   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is associated with a very poor prognosis, with near-identical incidence and mortality. According to the World Health Organization Globocan Database, the estimated number of new cases worldwide will rise by 70% between 2020 and 2040. There are no effective screening methods available so far, even for high-risk individuals. The prognosis of PDAC, even at its early stages, is still mostly unsatisfactory. Impaired glucose metabolism is present in about 3/4 of PDAC cases. METHODS: Available literature on pancreatic cancer and diabetes mellitus was reviewed using a PubMed database. Data from a national oncology registry (on PDAC) and information from a registry of healthcare providers (on diabetes mellitus and a number of abdominal ultrasound investigations) were obtained. RESULTS: New-onset diabetes mellitus in subjects older than 60 years should be an incentive for a prompt and detailed investigation to exclude PDAC. Type 2 diabetes mellitus, diabetes mellitus associated with chronic non-malignant diseases of the exocrine pancreas, and PDAC-associated type 3c diabetes mellitus are the most frequent types. Proper differentiation of particular types of new-onset diabetes mellitus is a starting point for a population-based program. An algorithm for subsequent steps of the workup was proposed. CONCLUSIONS: The structured, well-differentiated, and elaborately designed approach to the elderly with a new onset of diabetes mellitus could improve the current situation in diagnostics and subsequent poor outcomes of therapy of PDAC.

• Keywords
• age over 60 years, diagnostic algorithm, new-onset diabetes mellitus, pancreatic ductal adenocarcinoma,
• Publication type
• Journal Article MeSH
• Review MeSH