Diagnostic Utility of Non-invasive Steatosis and Fibrosis Biomarkers in Metabolic Dysfunction- Associated Steatotic Liver Disease Patients

Galal, Ghada M; Ali, Mohamed Abdulwahab Mohamed; Elsharkawy, Ramy M; Sayed, Sherif A.; Abd El Rahman, Noha M

doi:10.21608/asmj.2025.382386.1445

Diagnostic Utility of Non-invasive Steatosis and Fibrosis Biomarkers in Metabolic Dysfunction- Associated Steatotic Liver Disease Patients

Document Type : Original Article

Authors

¹ Tropical Medicine and Gastroenterology Department, Assiut University, Assiut, Egypt

² Tropical Medicine and Gastroenterology Department, Sohag University, Sohag, Egypt

³ Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt.

10.21608/asmj.2025.382386.1445

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a major causative agent of hepatic pathology-related to morbidity and mortality on a global scale. The detection of straightforward, non-surgical biomarkers for the diagnosis of MASLD holds great importance.
Aim: To investigate the reliability of serum biomarkers in determining the extent in investigating the severity of hepatic steatosis and fibrosis in individuals diagnosed with MASLD and analyzing the determinants of disease progression.
Methods: The current study enrolled 87 asymptomatic adults with bright liver on ultrasound. Steatosis/fibrosis were assessed using Transient Elastography. MASLD, this diagnostic approach adhered to internationally endorsed criteria.
Results: Of the 87 MASLD patients, moderate/ advanced steatosis was present in 68 patients (78.2%), and moderate/advanced fibrosis was found in 25 patients (28.7%). ROC curve analysis revealed that AUROCs of steatosis biomarkers were: FLI (0.681), HSI (0.676), and VAI (0.627) and TyG (0.566). Fatty degree by Ultrasound, and right hepatic lobe span were the significant predictors of moderate/ advanced steatosis in multiple logistic regression analysis. AUROCs of fibrosis scores were FIB-4 (0.949), APRI (0.868), NFS (0.632), BARD (0.615). FIB-4 was identified as the only significant factor associated with moderate or advanced fibrosis in the final regression model.
Conclusions: Fatty degree by ultrasound and right hepatic lobe span independently predicted moderate and advanced steatosis in MASLD patients, while FIB-4 served as the sole marker of moderate to advanced fibrosis among the patients evaluated. These simple tests may be used safely as an alternative to Transient Elastography where the machine is not available.

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