Observational studyBiology of sex differences2024
Fatty Liver Index (FLI) is the best score to predict MASLD with 50% lower cut-off value in women than in men.
Observational study in Biology of sex differences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled it.
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Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it.
- An updated systematic review and meta-analysis: correlation between circulating plasminogen activator inhibitor-1 levels and metabolic dysfunction-associated steatotic liver disease.BMC gastroenterology · 2025Pooled it
- The Supportive Effect of Acarbose to Orlistat in Weight Management-A Randomized, Double-Blind, Multiarm Phase 2 Trial.Obesity (Silver Spring, Md.) · 2025Trial
- Lactic acid bacteria and endogenous ethanol mediate proton pump inhibitor-associated MASLD: a multicohort cross-sectional mediation analysis.Gut microbes · 2026Article
- Article
- MASLD: Spatial Mechanisms and New Therapeutics.Biomolecules · 2026Review
- HFpEF and MASLD: converging mechanisms and clinical implications.Nature reviews. Cardiology · 2026Review
- Metabolic Dysfunction-Associated Steatotic Liver Disease as a Systemic Driver of Heart Failure With Preserved Ejection Fraction: Mechanistic Insights and Emerging Therapeutic Perspectives.Reviews in cardiovascular medicine · 2026Review
- Article
- Artificial intelligence predicts sex-specific risk of metabolic dysfunction-associated steatotic liver disease.Biology of sex differences · 2026Article
- Impact of body position on liver stiffness measurements in men and women with chronic liver disease: liver fibrosis assessed with shear wave elastography comb-push technology.BMC medical imaging · 2026Article
- The role of hepatic steatosis Index, fatty liver Index, and metabolic and hormonal biomarkers in differentiating MASLD in polycystic ovary syndrome.Journal of endocrinological investigation · 2026Article
- Serum uric acid-to-HDL-C ratio as an independent predictor of metabolic syndrome in the elderly: diagnostic model optimization and inflammatory mechanism insights.BMC geriatrics · 2026Article
- Subtype-specific associations of steatotic liver disease with gastric and esophageal cancers: a nationwide cohort study.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026Article
- Cross-trait genomic modeling reveals the polygenic architecture and systemic impact of MASLD.Science advances · 2026Article
- Applications of Artificial Intelligence and Smart Devices in Metabolic Dysfunction-associated Steatotic Liver Disease.Journal of clinical and translational hepatology · 2026Article
- PCSK9 inhibitors improve lipid profile and hepatic steatosis surrogate indicators in patients with MAFLD and type 2 diabetes.Frontiers in medicine · 2026Article
- Tirzepatide and metabolic dysfunction-associated steatotic liver disease (MASLD) in obesity: a real-world multicenter study.Frontiers in endocrinology · 2026Article
- Preoperative total cholesterol and axillary lymph node burden in breast cancer: an exploratory analysis with a preliminary nomogram.Frontiers in surgery · 2026Article
- Fatty liver index in early pregnancy predicts the risk of gestational diabetes mellitus.Frontiers in endocrinology · 2026Article
- High Prevalence of Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients with Hidradenitis Suppurativa: A Guide to Easily Assess the Clinical Risk of Comorbid Liver Disease.JID innovations : skin science from molecules to population health · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) is defined by the presence of hepatic steatosis, detected on ultrasonography (US) imaging or histology, and at least one of criteria for Metabolic Syndrome diagnosis. Simple non-invasive tests (NITs) have been proposed as an acceptable alternative when US and biopsy are not available or feasible but have not been validated for MASLD. In this observational study, we investigated the reliability of NITs for MASLD detection and whether sex-differences in screening methods should be considered.
methodsWe included 1069 individuals (48% males and 52% females) who underwent their first clinical examination for Metabolic Syndrome in the period between January 2015 and December 2022. Liver steatosis was detected through US and anthropometric and clinical parameters were recorded.
resultsLiver steatosis was detected in 648 patients and MASLD was diagnosed in 630 subjects (355 males; 275 females). Women with MASLD showed better metabolic profile and lower prevalence of Metabolic Syndrome criteria than men. Among NITs, Fatty Liver Index (FLI) showed the best ability for detection of MASLD, with a cut-off value of 44 (AUC = 0.82). When considering the two sexes for MASLD detection via FLI, despite no substantial differences regarding FLI correlations with metabolic biomarkers except for age, women showed marked lower FLI cut-off value (32; AUC = 0.80) than men (60; AUC = 0.80).
conclusionsIn this study, we found that FLI is the best non-invasive predictor of both liver steatosis and MASLD. The finding that in women FLI cut-off value for MASLD detection is 50% lower than in men suggests the need of a sex-specific personalized program of screening and prevention of dysmetabolism-related liver diseases, despite outwardly healthy biomarkers profile.
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