ArticleJournal of clinical medicine2020
Sequential Combination of FIB-4 Followed by M2BPGi Enhanced Diagnostic Performance for Advanced Hepatic Fibrosis in an Average Risk Population.
Article in Journal of clinical medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Pooled it
- Association of M2BPGi with Subclinical Atherosclerosis in Metabolic Dysfunction-Associated Steatotic Liver Disease.Metabolites · 2026Article
- Noninvasive strategies for metabolic dysfunction-associated steatotic liver disease assessment and referral in Japan.World journal of gastroenterology · 2026Review
- Sequential Fibrosis-4 Index and Mac-2 Binding Protein Glycosylation Isomer Combination Improve Detection of Advanced Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Multicenter Study.Gastro hep advances · 2026Article
- Imaging-based fibrosis assessment and risk stratification in MASLD.Frontiers in medicine · 2026Review
- Assessing the risk of metabolic dysfunction-associated steatotic liver disease in type 2 diabetes: is the Fibrosis-4 index still a reliable tool?Hepatobiliary surgery and nutrition · 2025Article
- Non-invasive blood biomarkers for assessment of liver fibrosis in metabolic dysfunction-associated steatotic liver disease.World journal of hepatology · 2025Review
- Value of Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) in Assessing Liver Fibrosis in Metabolic Dysfunction-Associated Liver Disease: A Comprehensive Review of its Serum Biomarker Role.Current protein & peptide science · 2025Review
- Three-Step Algorithm for Screening High-Risk Group of Metabolic Dysfunction-Associated Steatotic Liver Disease in General Population.Gut and liver · 2024Article
- Noninvasive Liver Fibrosis Staging: Comparison of MR Elastography with Extracellular Volume Fraction Analysis Using Contrast-Enhanced CT.Journal of clinical medicine · 2022Article
- Serum Wisteria floribunda agglutinin-positive Mac-2-binding protein expression predicts disease severity in nonalcoholic steatohepatitis patients.The Kaohsiung journal of medical sciences · 2022Article
- Predictive scoring system for advanced liver fibrosis in Japanese patients with severe obesity.Surgery today · 2021Article
- Diagnostic Efficacy of Serum Mac-2 Binding Protein Glycosylation Isomer and Other Markers for Liver Fibrosis in Non-Alcoholic Fatty Liver Diseases.Annals of laboratory medicine · 2021Article
- New sequential algorithm using Mac-2 binding protein glycosylation isomer to detect advanced carotid artery atherosclerosis.Annals of translational medicine · 2021Article
- FIB-4 First in the Diagnostic Algorithm of Metabolic-Dysfunction-Associated Fatty Liver Disease in the Era of the Global Metabodemic.Life (Basel, Switzerland) · 2021Review
- Article
- Epidemiology: Pathogenesis, and Diagnostic Strategy of Diabetic Liver Disease in Japan.International journal of molecular sciences · 2020Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The fibrosis-4 (FIB-4) index is the most widely used estimated formula to screen for advanced hepatic fibrosis; however, it has a considerable intermediate zone. Here, we propose an algorithm to reduce the intermediate zone and improve the diagnostic performance of screening for advanced liver fibrosis by incorporating Mac-2-binding protein glycan isomer (M2BPGi) into a FIB-4 based screening strategy in an average risk group. Four-hundred eighty-eight healthy and chronic liver disease subjects were analyzed using a 1:1 propensity score matched for age and sex. Advanced liver fibrosis (≥F3) was defined by magnetic resonance elastography (MRE, ≥3.6 kPa). Classification tree analysis was employed to improve diagnostic performance using a combination of the FIB-4 index and M2BPGi. The median serum M2BPGi levels of healthy subjects, patients without advanced fibrosis, and those with the condition were 0.48, 0.94, and 2.93, respectively. The area under the receiver operating characteristic (AUROC) curve of M2BPGi (0.918) for advanced fibrosis was the highest compared to those of the FIB-4 index (0.887), APRI (0.873), and AST/ALT ratio (0.794). When M2BPGi was incorporated following the FIB-4 index, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 87.1%, 82.5%, 54.0%, and 96.4%, respectively. Moreover, 74.3% (133/179) of cases in the intermediate zone of the FIB-4 index avoided unnecessary referrals. Two-step pathway (FIB-4 followed by M2BPGi) could reduce unnecessary referrals and/or liver biopsies in an average-risk population.
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