Younossi, Zobair M;
de Avila, Leyla;
Petta, Salvatore;
Hagström, Hannes;
Kim, Seung Up;
Nakajima, Atsushi;
Crespo, Javier;
... Global NASH/MASH Council (GNC); + view all
(2025)
Global performance of non-invasive tests in MASLD: Insights from the G-MASLD study.
Hepatology
10.1097/HEP.0000000000001564.
(In press).
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Abstract
BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent worldwide. Performance of non-invasive tests (NITs) in patients with MASLD recruited from different regions of the world were evaluated. METHODS: MASLD patients with liver biopsies and NIT data [FIB-4, ELF, liver stiffness measurement (LSM)] were enrolled through Global NASH Council collaboration (G-MASLD). FAST, Agile-3+/Agile-4 were calculated. NITs' performance for predicting ≥F2 (significant fibrosis), ≥F3 (advanced fibrosis) or cirrhosis (F4) was determined in patients from different regions. RESULTS: 17,792 MASLD patients from 41 countries were included: 14% had F0, 32% F1, 18% F2, 22% F3, 13% F4 (cirrhosis); 48% NAS ≥5. Advanced fibrosis prediction by NITs was variable across regions for FIB-4 (pooled AUC (95% CI)=0.80 (0.79-0.81)), the lowest in Latin America (0.75 (0.71-0.79)), the highest in MENA (0.84 (0.82-0.87)), and ELF (pooled AUC=0.77 (0.76-0.79) the lowest in Europe (0.72 (0.69-0.76)), the highest in North America (0.80 (0.78-0.82)). Prediction of advanced fibrosis by LSM (pooled AUC=0.84 (0.83-0.85)) was similar across regions except North America (0.78 (0.76-0.81)). In addition, FAST (AUC= 0.75 (0.74-0.76)) and Agile-3+ (AUC= 0.87 (0.86-0.88)) performed similarly across regions. Similar trends were observed for the NITs predicting significant fibrosis. Finally, accuracy of Agile-4 for predicting cirrhosis (AUC=0.90 (0.89-0.91)) was the lowest in North America (0.85 (0.83-0.87)), the highest in MENA (0.96 (0.94-0.98)). CONCLUSION: Diagnostic performance of common non-invasive tests for fibrosis in MASLD varies across the world. In the large multinational G-MASLD sample, the most accurate NITs were Agile-3+ and Agile-4 composite scores.
| Type: | Article |
|---|---|
| Title: | Global performance of non-invasive tests in MASLD: Insights from the G-MASLD study |
| Location: | United States |
| DOI: | 10.1097/HEP.0000000000001564 |
| Publisher version: | https://doi.org/10.1097/hep.0000000000001564 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | biomarkers, chronic liver disease, diagnostic thresholds, metabolic syndrome, non-communicable diseases, outcomes, steatohepatitis, steatotic liver disease |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10217235 |
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