We read with great interest the study by Mahmoudian et al. investigating soluble TREM2 (sTREM2) as a non-invasive biomarker for early metabolic dysfunction-associated steatohepatitis (MASH) [1]. The work valuably contributes to the urgent need for reliable serum markers in MASLD, demonstrating a strong association between plasma sTREM2 levels and histological severity in a well-phenotyped cohort. The reported AUC of 0.89 is promising. However, we wish to discuss two aspects where the methodology and interpretation could be further nuanced, which are critical for contextualizing these findings and guiding future research.
