ArticleHepatology forum2026
Discriminative performance of non-invasive scoring systems for VCTE-defined steatosis and fibrosis in patients with psoriasis.
Article in Hepatology forum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aim: Metabolic dysfunction-associated steatotic liver disease (MASLD) is more prevalent in patients with psoriasis. Reliable non-invasive tools are needed to evaluate hepatic steatosis and to identify patients at risk for significant liver fibrosis. This study aimed to assess the discriminative performance of commonly used non-invasive scoring systems for identifying patients with vibration-controlled transient elastography (VCTE)-defined significant liver fibrosis and hepatic steatosis in patients with psoriasis. Materials and Methods: A total of 113 patients with psoriasis were prospectively enrolled. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed using VCTE. Significant fibrosis (F2-F4) was defined as LSM ≥8 kPa, and significant steatosis (S2-S3) as CAP ≥259 dB/m. The discriminative performance of non-invasive fibrosis and steatosis scores was evaluated using area under the receiver operating characteristic (AUROC) curves. Results: Of the 113 patients, 76 (67%) were diagnosed with MASLD following VCTE assessment. The body mass index, aspartate aminotransferase-alanine aminotransferase ratio, and diabetes (BARD) score (AUROC=0.692) showed the highest performance in identifying significant fibrosis, while FIB-4, aspartate aminotransferase to platelet ratio index, non-alcoholic fatty liver disease fibrosis score (NFS), and steatosis-associated fibrosis estimator (SAFE) demonstrated lower predictive accuracy. Among patients with MASLD, the SAFE score (AUROC=0.776), followed by the BARD score (AUROC=0.716), yielded the highest discriminative performance. The SAFE score showed the highest negative predictive value (95%) for ruling out significant fibrosis in MASLD patients. For detecting significant steatosis, the fatty liver index (FLI) score (AUROC=0.867) provided the highest performance, while hepatic steatosis index (HSI) (AUROC=0.813) and metabolic dysfunction-associated fatty liver disease screening score (MAFLD-S) (AUROC=0.833) also demonstrated good discriminative ability. Conclusion: In patients with psoriasis, commonly used non-invasive fibrosis scores showed limited discrimination for VCTE-defined significant fibrosis, but they may have value as rule-out tools in low-prevalence settings. In contrast, FLI, HSI, and MAFLD-S showed good discrimination for VCTE-defined significant hepatic steatosis.
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