Clinical and Laboratory Factors of Advanced Fibrosis in Patients With Metabolic Dysfunction-Associated Steatohepatitis (MASH)

Background: Metabolic dysfunction-associated steatohepatitis (MASH) is most strongly linked to adverse outcomes by the presence and severity of advanced liver fibrosis.Identifying clinical and laboratory factors associated with advanced fibrosis may provide useful information for risk stratification, particularly in resource-limited settings.Methods: This analytical cross-sectional study included 700 adults with MASH who underwent transient elastography (FibroScan® system; Echosens, Paris, France) for fibrosis assessment.We categorized participants into two groups: non-advanced (F0-F2) and advanced (F3-F4) fibrosis.We compared the groups by demographics, metabolic comorbidities, anthropometric parameters, and lab parameters.We used multivariable binary logistic regression to identify independent factors associated with advanced fibrosis.Results: Overall, 219 participants (31.3%) had advanced fibrosis.Participants with advanced fibrosis had significantly higher mean age, BMI, waist circumference, AST, ALT, and HbA1c levels and significantly lower platelet count and serum albumin levels (all p < 0.001).Multivariable analysis showed that age (AOR = 1.068),BMI (AOR = 1.117), waist circumference (AOR = 1.036),AST (AOR = 1.019),ALT (AOR = 1.012), and HbA1c (AOR = 1.751) were independently associated with higher odds of advanced fibrosis.In contrast, higher serum albumin and platelet counts were inversely associated with advanced fibrosis.Conclusions: Routinely available clinical and laboratory parameters were independently associated with advanced fibrosis in patients with MASH and may provide useful information for risk stratification and prioritization of patients for further fibrosis assessment.These findings are exploratory and should be validated prospectively and in independent populations before clinical implementation, particularly in resource-limited settings.