Background: Nonalcoholic fatty liver disease (NAFLD) is a common hepatic disorder linked to metabolic syndrome. Endothelial dysfunction is crucial in NAFLD progression. Endocan, a marker of endothelial injury, has been studied in NAFLD, and we aim to systematically evaluate these findings.
Methods: PubMed, Scopus, Embase, and Web of Science were searched for studies measuring endocan levels in NAFLD patients compared to healthy controls. A random-effects meta-analysis was performed to estimate the standardized mean difference (SMD) with a 95% confidence interval (CI).
Results: Ten studies with 1045 participants (mean age 44.1 ± 9.8 years, 48.8% male) met inclusion criteria. Meta-analysis showed no significant difference in endocan levels between NAFLD patients and controls (SMD 0.03, 95% CI -0.59 to 0.65, p = 0.931). The diagnostic accuracy of endocan for NAFLD varied (AUC 0.647-0.867). Endocan was linked to endothelial dysfunction, atherosclerosis, and coronary artery disease in NAFLD patients.
Conclusion: Although serum endocan levels did not differ between NAFLD and controls, its role in endothelial dysfunction and disease prognosis suggests potential clinical relevance. Larger studies are needed to confirm these findings.
Keywords: ESM-1; Endocan; NAFLD; meta-analysis; nonalcoholic fatty liver disease; systematic review.