Key threshold identified for diagnosing advanced liver fibrosis in MASLD patients

A new study has identified a reference point for accurately identifying the degree of liver hardening in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).

A team of researchers led by Professor Kim Seung-up of the Department of Gastroenterology at Severance Hospital, Professor Yu Jung-hwan of the Department of Gastroenterology at Inha University Hospital, and Professor Chon Young-eun of the Department of Gastroenterology at CHA University Bundang Medical Center said Thursday that they have identified the best cut-off point for diagnosing advanced liver fibrosis, a hardening of the liver in patients with MASLD.

MASLD occurs when fat accumulates in the liver with metabolic diseases, such as high blood pressure and blood sugar. It can progress to severe liver disease or, worse, liver cancer. Furthermore, it is difficult to detect early due to the lack of symptoms, so regular screening is crucial. Fibrosis, the hardening of the liver, is an important prognostic indicator of MASLD.

To improve the accuracy of the non-invasive liver fibrosis diagnostics “instantaneous elastography” and “magnetic resonance elastography,” the research team analyzed all existing studies to identify the optimal threshold for diagnosing metabolic fatty liver disease.

Of the 72 studies deemed eligible for the study, the researchers analyzed data from more than 19,000 patients using elastography and over 1,400 patients using magnetic resonance elastography.

The results showed that 7.1 to 7.9 kPa (kilopascals) was the optimal threshold for diagnosing advanced liver fibrosis in patients with metabolic fatty liver disease, while 3.62 to 3.8 kPa (kilopascals) was the optimal threshold.

“The number of patients with metabolic fatty liver disease has been increasing in recent years, but there is a lack of practical information on non-invasive testing methods,” said Professor Kim, lead author of the study.

The findings were published in the Korean Journal of Hepatology's Clinical and Molecular Hepatology (CMH, IF 14).