SynthesisGastroenterology2022
Liver Stiffness on Magnetic Resonance Elastography and the MEFIB Index and Liver-Related Outcomes in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Individual Participants.
Synthesis in Gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 6 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
72 citing papers in PubMed, 6 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis.Clinical and molecular hepatology · 2024Pooled it
- KASL clinical practice guidelines for noninvasive tests to assess liver fibrosis in chronic liver disease.Clinical and molecular hepatology · 2024Guideline
- EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Obesity facts · 2024Guideline
- MEFIB-Index and MAST-Score in the assessment of hepatic decompensation in metabolic dysfunction-associated steatosis liver disease-Individual participant data meta-analyses.Alimentary pharmacology & therapeutics · 2023Pooled it
- Type 2 diabetes, hepatic decompensation, and hepatocellular carcinoma in patients with non-alcoholic fatty liver disease: an individual participant-level data meta-analysis.The lancet. Gastroenterology & hepatology · 2023Pooled it
- The Effects of Probiotics, Prebiotics and Synbiotics in Non-Alcoholic Fat Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH): A Systematic Review.International journal of molecular sciences · 2022Pooled it
- Therapeutic Efficacy of Silymarin, Vitamin E, and Essential Phospholipid Combination Therapy on Hepatic Steatosis, Fibrosis, and Metabolic Parameters in MASLD Patients: A Prospective Clinical Study.International journal of molecular sciences · 2025Trial
- Review
- Noninvasive surrogate endpoints in MASH trials: current perspectives and challenges.Hepatology international · 2026Review
- MAFLD/MASLD: Past, Present, and Future.Journal of gastroenterology and hepatology · 2026Review
- Steatotic liver disease: non-invasive assessment and biomarkers across metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction-associated steatotic liver disease with moderate alcohol consumption and alcohol-associated liver disease.Clinical and molecular hepatology · 2026Review
- MRI in MASLD: technical foundations and guideline-based applications.BMJ open gastroenterology · 2026Review
- HFpEF and MASLD: converging mechanisms and clinical implications.Nature reviews. Cardiology · 2026Review
- A Cost-Effectiveness Model of Semaglutide 2.4 mg, Resmetirom 80 mg, and Resmetirom 100 mg Versus Standard of Care for the Treatment of Metabolic Dysfunction-Associated Steatohepatitis in the United States.PharmacoEconomics · 2026Article
- Liver fibrosis in metabolic dysfunction-associated steatotic liver disease: epidemiology, risk stratification and therapeutics.BMJ open gastroenterology · 2026Review
- Detecting decompensation in cirrhotic patients with varying ascitic volumes using magnetic resonance elastography.Abdominal radiology (New York) · 2026Article
- Noninvasive liver fibrosis assessment in metabolic dysfunction-associated steatotic liver disease.World journal of hepatology · 2026Review
- Longitudinal Validation of Clinical Care Pathways for Metabolic Dysfunction-Associated Steatotic Liver Disease in a Prospective Cohort of Individuals With Type 2 Diabetes.Gastro hep advances · 2026Article
- Imaging-based fibrosis assessment and risk stratification in MASLD.Frontiers in medicine · 2026Review
- Focused Shear Wave Elastography to Assess Liver Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease.Gastro hep advances · 2026Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
18 authors at 8 institutions in 4 countries.
Funding
Abstract
BACKGROUND &
aimsMagnetic resonance elastography (MRE) is an accurate biomarker of liver fibrosis; however, limited data characterize its association with clinical outcomes. We conducted an individual participant data pooled meta-analysis on patients with nonalcoholic fatty liver disease to evaluate the association between liver stiffness on MRE and liver-related outcomes.
methodsA systematic search identified 6 cohorts of adults with nonalcoholic fatty liver disease who underwent a baseline MRE and were followed for hepatic decompensation, hepatocellular carcinoma, and death. Cox and logistic regression were used to assess the association between liver stiffness on MRE and liver-related outcomes, including a composite primary outcome defined as varices needing treatment, ascites, and hepatic encephalopathy.
resultsThis individual participant data pooled meta-analysis included 2018 patients (53% women) with a mean (± standard deviation) age of 57.8 (±14) years and MRE at baseline of 4.15 (±2.19) kPa, respectively. Among 1707 patients with available longitudinal data with a median (interquartile range) of 3 (4.2) years of follow-up, the hazard ratio for the primary outcome for MRE of 5 to 8 kPa was 11.0 (95% confidence interval [CI]: 7.03-17.1, P < .001) and for ≥ 8 kPa was 15.9 (95% CI: 9.32-27.2, P < .001), compared with those with MRE <5 kPa. The MEFIB index (defined as positive when MRE ≥3.3 kPa and Fibrosis-4 ≥1.6) had a robust association with the primary outcome with a hazard ratio of 20.6 (95% CI: 10.4-40.8, P < .001) and a negative MEFIB had a high negative predictive value for the primary outcome, 99.1% at 5 years. The 3-year risk of incident hepatocellular carcinoma was 0.35% for MRE <5 kPa, 5.25% for 5 to 8 kPa, and 5.66% for MRE ≥8 kPa, respectively.
conclusionLiver stiffness assessed by MRE is associated with liver-related events, and the combination of MRE and Fibrosis-4 has excellent negative predictive value for hepatic decompensation. These data have important implications for clinical practice.
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