Nearly 31.3% of adult patients diagnosed with metabolic dysfunction-associated steatohepatitis examined in an analytical cross-sectional study presented with advanced liver fibrosis. Out of 700 participants who underwent transient elastography using the FibroScan® system for fibrosis assessment, 219 individuals were categorized into the advanced fibrosis group, while the remaining participants fell into the non-advanced group.
The study contrasted demographic, metabolic, anthropometric, and laboratory parameters between participants with non-advanced and advanced fibrosis to determine independent risk factors. While advanced fibrosis is linked to significantly higher risks of hepatic decompensation, mortality, and hepatocellular carcinoma, liver biopsy remains invasive, expensive, and subject to complications. This dynamic leaves open the question of whether routinely available parameters can fully replace reference standards for risk stratification before prospective validation occurs.
Advanced Fibrosis Linked to Distinct Clinical and Laboratory Markers
Participants presenting with advanced fibrosis showed significantly higher mean age, body mass index, waist circumference, aspartate aminotransferase, alanine aminotransferase, and glycated hemoglobin levels. Conversely, those same individuals exhibited significantly lower platelet counts and serum albumin levels, with all comparisons registering a p < 0.001 threshold.
Multivariable binary logistic regression identified specific independent factors associated with higher odds of advanced fibrosis:
- Age, with an adjusted odds ratio of 1.068
- Body mass index, with an adjusted odds ratio of 1.117
- Waist circumference, with an adjusted odds ratio of 1.036
- Aspartate aminotransferase, with an adjusted odds ratio of 1.019
- Alanine aminotransferase, with an adjusted odds ratio of 1.012
- Glycated hemoglobin, with an adjusted odds ratio of 1.751
Meanwhile, higher serum albumin and platelet counts demonstrated an inverse association with advanced fibrosis.
Routine Parameters Show Risk Stratification Potential Requiring Independent Validation
The investigation suggests that routinely available clinical and laboratory parameters might offer useful information for risk stratification and prioritization of patients requiring further fibrosis assessment, particularly in resource-limited settings where access to imaging or proprietary biomarkers is restricted. However, researchers emphasize that these findings remain exploratory.
It is not yet known whether these routinely available parameters will successfully perform when implemented across independent populations, as the study’s authors note that the current results must be validated prospectively before clinical adoption can proceed.
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