ArticleHepatology communications2025
Noninvasive pathway for stratifying fibrosis in suspected metabolic dysfunction and alcohol-associated liver disease (MetALD).
Article in Hepatology communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- The global burden of metabolic and alcohol-associated liver disease (MetALD).Hepatology communications · 2026Review
- Alcohol-aware risk stratification and subtype-specific care pathways across metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction and alcohol-associated liver disease, and alcohol-associated liver disease.Clinical and molecular hepatology · 2026Review
- Risk assessment in metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction and alcohol-related liver disease: current approaches and future directions.Clinical and molecular hepatology · 2026Review
- Global epidemiology of metabolic and alcohol-associated liver disease: risk factors, natural history and clinical implications.Nature reviews. Gastroenterology & hepatology · 2026Review
- Subtype Differences in Major Adverse Liver Outcomes and Cardiovascular Events and Mortality in Steatotic Liver Disease: A UK Biobank Analysis.Alimentary pharmacology & therapeutics · 2026Article
- Global multicenter validation of noninvasive fibrosis assessment pathways in MetALD and ALD.Hepatology communications · 2026Article
- Dual-phase T1-mapping (DHR-MAP) for non-invasive assessment of advanced liver fibrosis and moderate hepatitis: a single-center validation study.BMC gastroenterology · 2026Article
- Blood-based non-invasive tests show comparable accuracy in MetALD and MASLD for MRE-defined advanced fibrosis.BMC gastroenterology · 2026Article
- Alcohol Abstinence Is Associated with Regression of Non-Invasive Fibrosis Markers in Patients with Metabolic Syndrome: A 12-Month Prospective Study.Journal of clinical medicine · 2026Article
- MetALD: decoding the evolution of steatotic liver disease nomenclature and implications for clinical practice and beyond.Gastroenterology report · 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
- Clinical trial design, biomarkers and end points in metabolic and alcohol-related liver disease.Nature reviews. Gastroenterology & hepatology · 2025Review
- MetALD: Diagnosis and Prognosis With Non-Invasive Tests.Alimentary pharmacology & therapeutics · 2025Article
- Association between metabolic dysfunction-associated fatty liver disease and cardiovascular autonomic neuropathy in type 2 diabetes.Frontiers in endocrinology · 2025Article
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Authors and funding
16 authors.
Funding
Abstract
backgroundMetabolic dysfunction and alcohol-associated liver disease (MetALD) may increase liver fibrosis progression, but data on screening are scarce. We aimed to assess the performance of noninvasive tests (NITs) for detecting significant fibrosis in individuals with suspected MetALD.
methodsThis is a cross-sectional study of prospectively enrolled adults identified as overweight or obese. We included adults with suspected MetALD defined by ≥1 of 5 cardiometabolic criteria and self-reported alcohol use within MetALD ranges or lower self-reported alcohol use but with phosphatidylethanol (PEth) levels ≥25 ng/mL. Clinical assessment included contemporaneous magnetic resonance elastography (MRE) and vibration-controlled transient elastography (VCTE). Significant fibrosis was defined as MRE ≥3.14 kPa (or VCTE ≥7.6 kPa if MRE was missing). Analyses included AUROCs.
resultsAmong 617 individuals screened, we identified 97 (15.7%) with suspected MetALD. The mean age was 50.6±12.8 years, 67% were men, the mean body mass index was 31.4±6.5 kg/m2, 12.4% had diabetes, and 8% had significant fibrosis. Fibrosis-4 ≥1.3 demonstrated good performance for significant fibrosis (AUROC: 0.78, 95% CI: 0.58-0.98, sensitivity 80%, specificity 76%, positive predictive value 17%, and negative predictive value 98%). VCTE ≥8 kPa also had good performance (AUROC: 0.85, 95% CI: 0.66-1.00, sensitivity 80%, specificity 91%, positive predictive value 36%, and negative predictive value 99%). A stepwise approach using fibrosis-4 followed by VCTE yielded a low false negative rate (2% misclassified as low risk).
conclusionsA clinical care algorithm utilizing a stepwise approach with fibrosis-4 and VCTE shows adequate performance in detecting significant fibrosis in individuals with suspected MetALD.
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