What question did this study set out to answer?

To develop a non-invasive fibrosis risk score using clinical and biochemical variables in a Mexican adult population.

March 13, 2026Open Access

Risk score to predict fibrosis among Mexican adults: results of the Health Workers Cohort Study

Puntos clave

To develop a non-invasive fibrosis risk score using clinical and biochemical variables in a Mexican adult population.
Included 295 participants from the Health Workers Cohort Study.
Used transient elastography (FibroScan) for fibrosis assessment.
Classified participants using the METAVIR system.
Evaluated candidate predictors with ROC curve analysis for diagnostic performance.
The new fibrosis risk score achieved an AUROC of 81.1%, indicating high diagnostic accuracy.
In a subsample with insulin measurements, the AUROC was 79.8%.
The developed risk score outperformed existing fibrosis scores like the BARD score in diagnostic accuracy.

Resumen

Background Fibrosis, a severe complication of metabolic-associated fatty liver disease, represents a major concern in the disease progression. Although liver biopsy remains the gold standard for fibrosis diagnosis, its invasive nature and high cost highlight the need for reliable non-invasive alternatives. Aim This study aimed to develop a simple, non-invasive fibrosis risk score based on clinical and biochemical variables in a Mexican population. Methods A total of 295 participants from the Health Workers Cohort Study were included. Fibrosis was assessed using transient elastography (FibroScan), which served as the reference standard for the development and validation of the risk score. Participants were classified according to the Meta-analysis of Histological Data in Viral Hepatitis (METAVIR) system. The diagnostic performance of candidate predictors was evaluated using receiver operating characteristic (ROC) curve analysis, and optimal cutoffs for fibrosis detection were identified. Results The fibrosis risk score developed for the Mexican population, including sex, triglycerides, glucose, waist circumference, hypertension, high-density lipoprotein cholesterol, body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and insulin, achieved an area under the ROC (AUROC) of 81.1% (95% CI, 74.4, 87.8). In the subsample with available insulin measurements, the AUROC was comparable (79.8, 95% CI, 72.9–86.8). When compared with existing fibrosis scores, including the BARD score (based on BMI, aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, and type 2 diabetes) and the AST/ALT ratio, the newly developed score demonstrated superior diagnostic accuracy for fibrosis detection. Conclusion This fibrosis risk score, based on routinely available clinical and biochemical data, demonstrated high diagnostic accuracy in the Mexican adult population. As a non-invasive tool, it may facilitate the early identification of fibrosis in primary care settings and reduce the need for liver biopsy. Further validation in larger and more diverse populations is warranted.

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