Lipids & metabolic liver disease
Screening for Metabolic Dysfunction–Associated Steatotic Liver Disease–Related Advanced Fibrosis in Diabetology: A Prospective Multicenter Study
Authors' conclusion
The FIB-4 score/VCTE algorithm showed excellent diagnostic performance, demonstrating its applicability for routine screening in diabetology. The ELF test using an adapted low threshold at 9.8 may be used as an alternative to VCTE.
Study context
- Population
- Patients with T2D and/or obesity and MASLD in diabetology; 87% T2D, 56% male, 74% with obesity
- Participants
- 654 patients
- Comparison
- Blood-based noninvasive tests (NITs), vibration-controlled transient elastography (VCTE) and 2D-SWE vs two-step algorithms (FIB-4 then second test) for detecting high risk of advanced fibrosis (AF)
- Outcome
- Detection of high risk of AF (composite reference:
- Liver biopsy
- Magnetic resonance elastography
- VCTE ≥12 kPa depending on availability)
Methodological detailsprospective, multicenter, planned interim analysis
- Prospective
- Multicenter
- Planned interim analysis
Performance
As reported in the abstract
Detection of high risk of AF
| Test or model | AUC | Performance | NPV | PPV |
|---|---|---|---|---|
| FIB-4 | 0.78 (95% CI 0.72-0.84) | |||
| FibroMeter | 0.74 (0.66-0.83) | |||
| FibroTest | 0.78 (0.72-0.85) | |||
| Enhanced Liver Fibrosis (ELF) | 0.82 (0.76-0.87) | |||
| SWE | 0.84 (0.78-0.89) | |||
| FIB-4/VCTE | good diagnostic performance for referral of intermediate/high risk of AF | |||
| FIB-4/ELF | 88-89% | 39-46% | ||
| FIB-4/2D-SWE | 91% | 58-62% |
AUC
FIB-40.78 (95% CI 0.72-0.84)
FibroMeter0.74 (0.66-0.83)
FibroTest0.78 (0.72-0.85)
Enhanced Liver Fibrosis (ELF)0.82 (0.76-0.87)
SWE0.84 (0.78-0.89)
FIB-4/VCTE— not stated in the abstract
FIB-4/ELF— not stated in the abstract
FIB-4/2D-SWE— not stated in the abstract
Performance
FIB-4— not stated in the abstract
FibroMeter— not stated in the abstract
FibroTest— not stated in the abstract
Enhanced Liver Fibrosis (ELF)— not stated in the abstract
SWE— not stated in the abstract
FIB-4/VCTEgood diagnostic performance for referral of intermediate/high risk of AF
FIB-4/ELF— not stated in the abstract
FIB-4/2D-SWE— not stated in the abstract
NPV
FIB-4— not stated in the abstract
FibroMeter— not stated in the abstract
FibroTest— not stated in the abstract
Enhanced Liver Fibrosis (ELF)— not stated in the abstract
SWE— not stated in the abstract
FIB-4/VCTE— not stated in the abstract
FIB-4/ELF88-89%
FIB-4/2D-SWE91%
PPV
FIB-4— not stated in the abstract
FibroMeter— not stated in the abstract
FibroTest— not stated in the abstract
Enhanced Liver Fibrosis (ELF)— not stated in the abstract
SWE— not stated in the abstract
FIB-4/VCTE— not stated in the abstract
FIB-4/ELF39-46%
FIB-4/2D-SWE58-62%
Further findings
Prevalence of AF risk
- Intermediate/high risk of AF
- 17.6%
- High risk of AF
- 9.3%
Age-adapted FIB-4 threshold
- Lower NPVs and PPVs in all algorithms
Original publication
Screening for Metabolic Dysfunction–Associated Steatotic Liver Disease–Related Advanced Fibrosis in Diabetology: A Prospective Multicenter Study. Diabetes Care. Published 31 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →