The liver handles metabolism and filters toxins, but Metabolic dysfunction-associated steatotic liver disease can turn healthy tissue into scarred tissue. A new narrative review explains how a family of proteins called IGFBPs acts differently depending on which member of the group is present. These proteins are not all the same, and their roles change as the disease gets worse.
Some members like IGFBP1 and IGFBP2 offer metabolic protection. They help the body burn fat better and make cells more sensitive to insulin. This helps keep the liver healthy during early stages. However, other members like IGFBP3 and IGFBP5 have a mixed effect. They stop fat buildup at first but then hurt liver cells and activate scar-forming cells during later stages.
IGFBP7 takes a harmful path. It blocks insulin signals, triggers a type of cell death called ferroptosis, and encourages fibrosis or scarring. The review notes that IGFBP4 and IGFBP6 are not well understood yet. Because these proteins act differently, they could serve as markers to stage disease or as targets for new treatments. The evidence comes from a review rather than a single large trial, so the picture is still forming.