Non-invasive tools to predict fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD). The results of the prospective study from the Hepatology Tertiary Center from Iasi

FROM IASI (Abstract): Metabolic dysfunction-associated steatotic liver disease (MASLD) previously known as non-alcoholic fatty liver disease (NAFLD), represents nowadays the most common cause of chronic liver disease.The gold-standard method for assessing the degree of steatosis and fibrosis is liver biopsy (invasive method).The aim of the study was to establish the role of noninvasive testing (serological and imagistic) in identifying MASLD patients at higher risk to d evelop advanced fibrosis.Materials and methods: a total of 111 patients with MASLD was tested for fibrosis using non-invasive tests.Serological test that were used consisted in the NAFLD fibrosis score (NFS), Fibrosis Index for liver fibrosis (FIB-4) and BARD.Imagistic method consisted in 2D shear wave elastography (2D-SWE.GE elastography).Results: The majority of patients (54.9%) had significant fibrosis (F2-F4).The degree of liver fibrosis assessed by 2D-SWE.GE elastography could have been correlated with a range of serological parameters.Liver transaminase values were, in the majority of subjects, the only changes detec ted.The increase was moderate, and the ASAT/ALAT ratio was subunit.We found statistically significant differences between subgroups of patients with and without advanced fibrosis in the following parameters: BMI, platelets, albumin, blood glucose.All three types of testing identified the cases with significant fibrosis.NFS testing correlated best with advanced fibrosis estimated from 2D-SWE.GE elastometry.Conclusions: Serological and imagistic tests are validated tools to predict advanced fibrosis in MASLD patients.The limitation of the study is the relatively small number of patients and the lack of reporting on liver biopsy.