'Agile score effectively predicts outcomes in fatty liver disease patients'

Researchers at Severance Hospital have proved that the "Agile score," a test for identifying cirrhosis in metabolic dysfunction-associated steatotic liver disease (MASLD) patients, can accurately predict the prognosis of patients with metabolic dysfunction associated with fatty liver disease.

The Agile score system utilizes liver fibrosis scan results to stratify patients into risk categories for severe liver complications.

Fatty liver disease, which affects about 30 percent of the population, occurs when fat constitutes more than 5 percent of the liver's weight.

Traditionally known as non-alcoholic fatty liver disease (NAFLD), the condition's terminology has shifted towards MAFLD to emphasize its association with metabolic abnormalities. The disease can progress to serious conditions such as severe liver fibrosis, cirrhosis, and even liver cancer.

To validate the efficacy of the Agile score model, the team, led by Professors Kim Seung-up and Lee Hye-won of the Department of Internal Medicine at Severance Hospital, used the results of liver fibrosis scans from 16,603 patients across 16 hospitals worldwide in the U.S., Europe, and Asia, and calculated the Agile scores and compared them to actual liver-related complications that occurred.

The incidence of liver-related complications was 1.9 percent, and the Agile test boasted high predictive accuracy. It performed similarly to or better than other non-invasive tests, and while not superior to histologically confirmed degrees of fibrosis, it showed comparable performance.

Furthermore, the team confirmed that regular Agile tests could track changes in prognosis improvement or deterioration in patients who had undergone at least two liver fibrosis scans.

Among 1,920 patients, 81.9 percent and 92.1 percent maintained their initial risk scores in Agile 3+ and Agile 4 follow-up tests, respectively.

Patients in the low-risk group who did not see an increase in their Agile 3+ score had about eight times fewer complications compared to those who remained in the high-risk group.

No complications occurred when high-risk patients with Agile 3+ scores moved to the low-risk category. This highlights the importance of consistent Agile testing.

"The Agile score, based on liver fibrosis scans, helps in accurately predicting the prognosis of patients with metabolic dysfunction associated fatty liver disease," Professor Kim said.

Professor Lee also said, "Through prognosis prediction, it is expected that patients who need active surveillance and treatment can be identified."

The research results were published in the Journal of the American Medical Association.