acFibroMASH Index for the Diagnosis of Fibrotic MASH and Prediction of Liver-related Events: An International Multicenter Study.
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Feng Gong, Mózes Ferenc E, Ji Dong, Treeprasertsuk Sombat, Okanoue Takeshi, Shima Toshihide, Liang Huiqing, Tsochatzis Emmanuel, Chen Jinjun, Schattenberg Jörn M, Labenz Christian, Mahadeva Sanjiv, Chan Wah Kheong, Chi Xiaoling, Delamarre Adèle, de Lédinghen Victor, Petta Salvatore, Bugianesi Elisabetta, Hagström Hannes, Boursier Jérôme, Calleja José Luis, Goh George Boon-Bee, Gallego-Durán Rocio, Sanyal Arun J, Fan Jian-Gao, Castéra Laurent, Lai Michelle, Harrison Stephen A, Romero-Gomez Manuel, Kim Seung Up, Zhu Yongfen, Ooi Geraldine, Shi Junping, Yoneda Masato, Nakajima Atsushi, Zhang Jing, Lupsor-Platon Monica, Zhong Bihui, Cobbold Jeremy F L, Ye Chun-Yan, Eddowes Peter J, Newsome Philip, Li Jie, George Jacob, He Fangping, Song Myeong Jun, Tang Hong, Fan Yuchen, Jia Jidong, Xu Liang, Lin Su, Li Yiling, Lu Zhonghua, Nan Yuemin, Niu Junqi, Yan Xuebing, Zhou Yongjian, Liu Chenghai, Deng Hong, Ye Qing, Zeng Qing-Lei, Li Lei, Wang Jing, Yang Song, Lin Huapeng, Lee Hye Won, Yip Terry Cheuk-Fung, Fournier-Poizat Céline, Wong Grace Lai-Hung, Pennisi Grazia, Armandi Angelo, Liu Wen-Yue, Shang Ying, de Saint-Loup Marc, Llop Elba, Teh Kevin Kim Jun, Lara-Romero Carmen, Asgharpour Amon, Mahgoub Sara, Chan Mandy Sau-Wai, Canivet Clemence M, Ji Fanpu, Xin Yongning, Chai Jin, Dong Zhiyong, Targher Giovanni, Byrne Christopher D, He Na, Mi Man, Ye Feng, Wong Vincent Wai-Sun, Pavlides Michael, Zheng Ming-Hua
Аннотация
METHODS: We analyzed data from 3004 individuals with biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD) across 29 Chinese and 9 international cohorts to validate the acMASH index and develop the acFibroMASH index. Additionally, we utilized the independent external data from a multi-national cohort of 9034 patients with MASLD to examine associations between the acFibroMASH index and the risk of LREs.
RESULTS: In the pooled global cohort, the acMASH index identified MASH with an area under the receiver operating characteristic curve (AUROC) of 0.802 (95% confidence interval [CI], 0.786-0.818). The acFibroMASH index (including the acMASH index plus liver stiffness measurement) accurately identified fibrotic MASH with an AUROC of 0.808 in the derivation cohort and 0.800 in the validation cohort. Notably, the AUROC for the acFibroMASH index was 0.835 (95% CI, 0.786-0.882), superior to that of the FAST score at 0.750 (95% CI, 0.693-0.800; P < .01) in predicting the 5-year risk of LREs. Patients with acFibroMASH >0.39 had a higher risk of LREs than those with acFibroMASH <0.15 (adjusted hazard ratio, 11.23; 95% CI, 3.98-31.66).
CONCLUSIONS: This multi-ethnic study validates the acMASH index as a reliable, noninvasive test for identifying MASH. The newly proposed acFibroMASH index is a reliable test for identifying fibrotic MASH and predicting the risk of LREs.