Diagnostic performances of Fibrosis‐4 index and nonalcoholic fatty liver disease fibrosis score in metabolic dysfunction‐associated steatotic liver disease in Asian primary care clinics

• Published in: Hepatology research Vol. 54; no. 11; pp. 1027 - 1034
• Main Authors: Park, Huiyul, Kim, Mimi, Kim, Hye‐Lin, Cho, Seon, Yoon, Eileen L., Jun, Dae Won
• Format: Journal Article
• Language: English
• Published: Netherlands Wiley Subscription Services, Inc 01.11.2024
• Subjects: advanced hepatic fibrosis; Fatty liver; Fibrosis; Fibrosis‐4 index; Liver diseases; metabolic dysfunction‐associated steatotic liver disease; Metabolism; Nomenclature; nonalcoholic fatty liver disease; nonalcoholic fatty liver disease fibrosis score; Primary care; Ultrasonic imaging; advanced hepatic fibrosis; nonalcoholic fatty liver disease; Fibrosis‐4 index; metabolic dysfunction‐associated steatotic liver disease; nonalcoholic fatty liver disease fibrosis score
• ISSN: 1386-6346; 1872-034X
• DOI: 10.1111/hepr.14054

Aims We aimed to explore the extent to which individuals previously diagnosed with nonalcoholic fatty liver disease (NAFLD) meet the criteria fulfilled with the new nomenclature, metabolic dysfunction‐associated steatotic liver disease (MASLD), within an Asian primary clinic cohort. Additionally, we assessed the reliability of the diagnostic performance of FIB‐4 and NAFLD fibrosis score (NFS) for MASLD within the primary clinic cohort. Methods This retrospective cross‐sectional study included participants who underwent magnetic resonance elastography and abdominal ultrasonography during their health checkups at nationwide health promotion centers (n = 6740). Results The prevalence rates of NAFLD and MASLD diagnosed based on ultrasonography results were 36.7% and 38.0%, respectively. Notably, 96.8% of patients in the NAFLD cohort fulfilled the new criteria for MASLD. A small proportion of patients with NAFLD (n = 80, 3.2%) did not meet the MASLD criteria. Additionally, 168 patients (6.6%) were newly added to the MASLD group. The areas under the receiver operating characteristic curves for diagnosing advanced hepatic fibrosis for FIB‐4 (0.824 in NAFLD vs. 0.818 in MASLD, p = 0.891) and NFS (0.803 in NAFLD vs. 0.781 in MASLD, p = 0.618) were comparable between the MASLD and NAFLD groups. Furthermore, the sensitivity, specificity, positive predictive value, and negative predictive value of FIB‐4 and NFS for advanced fibrosis in MASLD were also comparable to those in NAFLD. Conclusions Most patients (96.8%) previously diagnosed with NAFLD fulfilled the new criteria for MASLD in an Asian primary clinic cohort. Diagnostic performance of FIB‐4 in the MASLD cohort demonstrated satisfactory results. Most patients (96.8%) in the nonalcoholic fatty liver disease (NAFLD) cohort fulfilled the new criteria for metabolic dysfunction‐associated steatotic liver disease (MASLD). The diagnostic performance of FIB‐4 and the NAFLD fibrosis score (NFS) for advanced fibrosis between MASLD and NAFLD was comparable.