We commend Mahmoudian et al. for their insightful study investigating soluble TREM2 (sTREM2) as a noninvasive biomarker for early metabolic dysfunction-associated steatohepatitis (MASH) in women with severe obesity [1]. The integration of plasma sTREM2 levels with hepatic TREM2 expression and macrophage infiltration provides valuable mechanistic insights. However, several methodological limitations—beyond those acknowledged—merit rigorous scrutiny to ensure clinical translatability.
