Evidence map›Paper›PMID 41698414›Full record

ArticleJournal of gastroenterology and hepatology2026

A Novel Fibroblast Activation Protein-Based Algorithm to Assess Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease.

Ziqi V Wang, Badwi B Boumelhem, Torsten Pennell, William W Bachovchin, Jack Hung-Sen Lai, Sarah E Poplawski, Harsha Chandraratna, Pieter Van Der Veken, Kate Brewer, Diana Julie Leeming and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastroenterology and hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Ziqi V WangLiver Enzymes in Metabolism and Inflammation, Centenary Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0009-0005-2725-4689
Badwi B BoumelhemLiver Enzymes in Metabolism and Inflammation, Centenary Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-1158-123X
Torsten PennellLiver Enzymes in Metabolism and Inflammation, Centenary Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
William W BachovchinDepartment of Developmental, Molecular and Chemical Biology, Graduate School of Biomedical Sciences, Tufts University, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-9926-7244
Jack Hung-Sen LaiDepartment of Developmental, Molecular and Chemical Biology, Graduate School of Biomedical Sciences, Tufts University, Boston, Massachusetts, USA.ORCID https://orcid.org/0009-0003-4566-1961
Sarah E PoplawskiDepartment of Developmental, Molecular and Chemical Biology, Graduate School of Biomedical Sciences, Tufts University, Boston, Massachusetts, USA.ORCID https://orcid.org/0009-0009-8884-9730
Harsha ChandraratnaObesity Surgery WA, Booragoon, Western Australia, Australia.
Pieter Van Der VekenLaboratory of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Antwerp, Wilrijk, Belgium.ORCID https://orcid.org/0000-0003-1208-3571
Kate BrewerLiver Enzymes in Metabolism and Inflammation, Centenary Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Diana Julie LeemingNordic Bioscience A/S, Herlev, Denmark.ORCID https://orcid.org/0000-0002-4256-140X
Geraldine OoiDepartment of Surgery, Monash University, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-4540-408X
Jacob GeorgeStorr Liver Centre, The Westmead Institute for Medical Research, Westmead Hospital and the University of Sydney, Westmead, New South Wales, Australia.ORCID https://orcid.org/0000-0002-8421-5476
Mohammed EslamStorr Liver Centre, The Westmead Institute for Medical Research, Westmead Hospital and the University of Sydney, Westmead, New South Wales, Australia.ORCID https://orcid.org/0000-0002-4315-4144
Leon A AdamsMedical School, Faculty of Medicine and Health Sciences, The University of Western Australia, Perth, Western Australia, Australia.ORCID https://orcid.org/0000-0002-3968-7909
Hui Emma ZhangLiver Enzymes in Metabolism and Inflammation, Centenary Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-4699-4237
Geoffrey W McCaughanLiver Enzymes in Metabolism and Inflammation, Centenary Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-1483-1636
Avik MajumdarLiver Enzymes in Metabolism and Inflammation, Centenary Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0003-2975-4327
Mark D GorrellLiver Enzymes in Metabolism and Inflammation, Centenary Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-0528-2604

Funding

Centenary Institute Foundation 2021/ATRG2028Gilead FellowshipHollywood Private Hospital Research FoundationNational Health and Medical Research Council APP1053206National Health and Medical Research Council APP1105238National Health and Medical Research Council APP1107178National Health and Medical Research Council APP1108422Rebecca L. Cooper Medical Research FoundationRobert W. Storr Bequest to the Sydney Medical FoundationSir Charles Gairdner Osborne Parke Health Care Group
6 · The paper itself

Abstract

backgroundNoninvasive fibrosis testing is crucial for metabolic dysfunction-associated steatotic liver disease (MASLD) management. This study evaluated a marker of activated mesenchymal fibrogenic cells, circulating fibroblast activation protein (cFAP), in a novel diagnostic algorithm, FAP Index, for patients with MASLD.

methodsTwo retrospective cohorts recruited from tertiary hepatology clinics were studied as training (n = 160) and external validation cohorts (n = 332), with prevalence of histologic advanced fibrosis (F3-F4) of 20% and 11%, respectively. cFAP was measured using our rapid single-step FAP-specific microplate enzyme assay. A predictive model, FAP Index, containing age, type 2 diabetes, alanine transaminase, and ordinal cFAP was developed using logistic regression; then, its diagnostic accuracy was evaluated.

resultsFAP Index AUROC for advanced fibrosis was 0.875 (95% CI: 0.813-0.938) in the training cohort and 0.841 (95% CI: 0.776-0.906) in the validation cohort. Low cutoff 0.157 (sensitivity 84.3%, negative predictive value 95%) and high cutoff 0.695 (specificity 99.2%, positive predictive value 92.9%) values excluded and predicted advanced fibrosis, respectively. FAP Index following FIB-4 reduced the frequency of indeterminate results by more than one-third compared to FIB-4 alone. FAP Index following NFS (NAFLD Fibrosis Score) reduced the frequency of indeterminate results by ~70% compared to NFS alone.

conclusionWithout a need for elastography, applying FAP Index following FIB-4 or NFS can facilitate accurate risk stratification of patients by greatly reducing the frequency of indeterminate results compared to FIB-4 or NFS alone, without compromising negative predictive value. Thus, FAP Index is a novel, fibrogenesis-relevant, rapid, robust diagnostic tool suited to increasing the efficiency of liver fibrosis triage in primary care.

Indexed as

AlgorithmsFatty LiverGelatinasesLiver CirrhosisMembrane ProteinsSerine EndopeptidasesBiomarkersEndopeptidasesFemaleFibroblast Activation Protein AlphaHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesSensitivity and SpecificityBiomarkersEndopeptidasesFibroblast Activation Protein AlphaGelatinasesMembrane ProteinsSerine EndopeptidasesFAP IndexFIB‐4fibroblast activation proteinfibrosisnoninvasive test

Identifiers

PMID41698414
PMCPMC13058791

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.