Noninvasive pathway for stratifying fibrosis in suspected metabolic dysfunction and alcohol-associated liver disease (MetALD)

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dc.article.numbere0718
dc.catalogadorvzp
dc.contributor.authorDiaz Piga, Luis Antonio
dc.contributor.authorTavaglione, Federica
dc.contributor.authorMittal, Nikita
dc.contributor.authorBettencourt, Ricki
dc.contributor.authorAmangurbanova, Maral
dc.contributor.authorJohnson, Amy
dc.contributor.authorMarti-Aguado, David
dc.contributor.authorTincopa, Monica
dc.contributor.authorLoomba, Ria
dc.contributor.authorKhan-Riches, Asma
dc.contributor.authorMadamba, Egbert
dc.contributor.authorSiddiqi, Harris
dc.contributor.authorRichards, Lisa
dc.contributor.authorSirlin, Claude B.
dc.contributor.authorAjmera, Veeral
dc.contributor.authorLoomba, Rohit
dc.date.accessioned2025-05-22T19:31:06Z
dc.date.available2025-05-22T19:31:06Z
dc.date.issued2025
dc.description.abstractBackground: Metabolic dysfunction and alcohol-associated liver disease (MetALD) may increase liver fibrosis progression, but data on screening are scarce. We aimed to assess the performance of noninvasive tests (NITs) for detecting significant fibrosis in individuals with suspected MetALD.Methods: This is a cross-sectional study of prospectively enrolled adults identified as overweight or obese. We included adults with suspected MetALD defined by ≥1 of 5 cardiometabolic criteria and self-reported alcohol use within MetALD ranges or lower self-reported alcohol use but with phosphatidylethanol (PEth) levels ≥25 ng/mL. Clinical assessment included contemporaneous magnetic resonance elastography (MRE) and vibration-controlled transient elastography (VCTE). Significant fibrosis was defined as MRE ≥3.14 kPa (or VCTE ≥7.6 kPa if MRE was missing). Analyses included AUROCs.Results: Among 617 individuals screened, we identified 97 (15.7%) with suspected MetALD. The mean age was 50.6±12.8 years, 67% were men, the mean body mass index was 31.4±6.5 kg/m2, 12.4% had diabetes, and 8% had significant fibrosis. Fibrosis-4 ≥1.3 demonstrated good performance for significant fibrosis (AUROC: 0.78, 95% CI: 0.58–0.98, sensitivity 80%, specificity 76%, positive predictive value 17%, and negative predictive value 98%). VCTE ≥8 kPa also had good performance (AUROC: 0.85, 95% CI: 0.66–1.00, sensitivity 80%, specificity 91%, positive predictive value 36%, and negative predictive value 99%). A stepwise approach using fibrosis-4 followed by VCTE yielded a low false negative rate (2% misclassified as low risk).Conclusions: A clinical care algorithm utilizing a stepwise approach with fibrosis-4 and VCTE shows adequate performance in detecting significant fibrosis in individuals with suspected MetALD.
dc.fechaingreso.objetodigital2025-05-22
dc.format.extent12 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1097/HC9.0000000000000718
dc.identifier.urihttps://doi.org/10.1097/HC9.0000000000000718
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/104451
dc.information.autorucEscuela de Medicina; Diaz Piga, Luis Antonio; 0000-0002-8540-4930; 179253
dc.issue.numero6
dc.language.isoen
dc.nota.accesocontenido completo
dc.revistaHepatology Communications
dc.rightsacceso abierto
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
dc.rights.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0
dc.subjectFIB-4,
dc.subjectFibrosis-4
dc.subjectMASH
dc.subjectMASLD
dc.subjectMetabolic dysfunction-associated steatohepatitis
dc.subjectNon-invasive testing
dc.subjectSteatotic liver disease
dc.subjectTransient elastography
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleNoninvasive pathway for stratifying fibrosis in suspected metabolic dysfunction and alcohol-associated liver disease (MetALD)
dc.typeartículo
dc.volumen9
sipa.codpersvinculados179253
sipa.trazabilidadORCID;2025-05-19
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