A Fully Integrated Wearable Sensor for Real Time Monitoring of Multiple Sweat Liver Disease Biomarkers

Early diagnosis and personalized management of chronic liver disease are critical for preventing disease progression and reducing mortality. However, existing diagnostic methods primarily depend on invasive blood sampling and laboratory-based analyses, which limit their suitability for continuous, real-world monitoring. In this study, we developed a skin-conformal, wearable electrochemical biosensing platform capable of real time monitoring of liver health by continuously analyzing liver-related metabolic biomarkers (creatine and lactate) in sweat. To improve sensor reliability, we introduced a universal enzyme immobilization strategy based on covalent organic frameworks, which enhances enzymatic stability and maintains catlytic activity under dynamic conditions. The fully integrated system supports efficient passive sweat collection, real time multi-analyte detection, on-board signal processing, and digital display. The platform was applied in preliminary human studies to track dynamic changes in sweat creatine and lactate in healthy individuals and participants with chronic liver disease. Overall, this work demonstrates a versatile wearable platform for noninvasive, continuous assisted evaluation of liver metabolic functions, contributing to the advancement of next-generation personalized healthcare technologies.