ArticleGastroenterology2026
The MetALD-ALD Prediction Index: A Phosphatidylethanol-Driven Biomarker Panel for Identifying Individuals With Steatotic Liver Disease and Excessive Alcohol Use.
Article in Gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Missed Diagnosis in Alcohol-Related Hepatocellular Carcinoma: A Call for Alcohol Consumption and Liver Disease Early Detection.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- MetALD-ALD prediction index exposes an unresolved reassignment rule in MetALD.Hepatobiliary surgery and nutrition · 2026Article
- 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
- Genetic and genomic insights across the steatotic liver disease spectrum.Clinical and molecular hepatology · 2026Review
- Global epidemiological patterns and disease burden of metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction and alcohol-associated liver disease, and alcohol-associated liver disease.Clinical and molecular hepatology · 2026Review
- MetALD Molecular Signatures: What We Know, What We Lack, and How to Move Forward Through Integrated Multi-Omics.Metabolites · 2026Review
- Implementation of evidence-based alcohol policies to reduce alcohol-related harm and liver disease to advance public health in Europe.The Lancet regional health. Europe · 2026Review
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12 authors.
Funding
Abstract
BACKGROUND &
aimsPhosphatidylethanol (PEth) is a direct, objective alcohol biomarker for detecting excessive alcohol use in steatotic liver disease, including metabolic dysfunction and alcohol-associated liver disease (MetALD) and alcohol-associated liver disease (ALD). However, its use in routine clinical practice may be limited by cost and accessibility. This study aimed to develop a novel, accurate, and scalable indirect alcohol biomarker panel to screen for MetALD-ALD in general population settings.
methodsThe derivation cohort consisted of 503 community-dwelling adults with overweight/obesity and steatotic liver disease residing in Southern California, all of whom prospectively underwent magnetic resonance imaging/magnetic resonance elastography assessment and PEth testing. The optimal predictive model was developed using bidirectional stepwise logistic regression and internally validated using 2000 bootstrap samples. The outcome was the presence of MetALD-ALD, defined by incorporating PEth. Model performance was evaluated using area under the receiver operating characteristic curve (AUROC). External validation was conducted in an independent, population-based Swedish cohort of 1777 individuals with available PEth measurements.
resultsIn the derivation cohort, the mean (standard deviation) age and body mass index were 51 (13) years and 32.9 (5.8) kg/m
conclusionsMAPI is a novel, accurate, and scalable biomarker panel for detecting MetALD-ALD. MAPI may guide confirmatory PEth testing in clinical practice and be leveraged in observational cohort studies lacking PEth measurements, as well as in clinical trials.
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