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MAFLD identifies patients with significant hepatic fibrosis better than MASLD

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Abstract

Background and aims

Diagnostic criteria for metabolic dysfunction-associated steatotic liver disease (MASLD) have been proposed but not yet validated. This study aimed to compare the diagnostic accuracy of the MASLD definition with the existing criteria for metabolic dysfunction-associated fatty liver disease (MAFLD) in identifying patients with significant fibrosis.

Methods

The analysis included a total of 8317 individuals who had complete biochemical and liver ultrasonography data from the National Health and Nutrition Examination Survey (2017–2020). In this study, significant fibrosis (≥ F2) was determined by a median liver stiffness of ≥ 8.0 kPa. To identify independent factors associated with significant fibrosis, multivariable logistic regression analyses were applied.

Results

MAFLD (OR 3.44; 95% CI 2.88–4.12; P < 0.0001) has a trend for stronger and independent association with significant fibrosis compared to MASLD (OR 2.63; 95% CI 2.22–3.11; P < 0.0001). Non-MASLD MAFLD is independently associated with a 14.28-fold higher odds of significant fibrosis compared to non-MAFLD MASLD. The sensitivity for detecting significant fibrosis for MAFLD and MASLD was 76.23% vs 69.94%, respectively. The performance of MAFLD remains consistent in a sub-analysis of patients with no or mild alcohol intake.

Conclusions

The definition of MAFLD provides a more precise identification of individuals who have both fatty liver and significant fibrosis, assessed by non-invasive tests.

Graphical Abstract

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Data availability

Not applicable.

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Acknowledgements

ME is supported by a National Health and Medical Research Council of Australia (NHMRC) Program Grant (APP1053206) and Project and ideas grants (APP2001692, APP1107178 and APP1108422).

Funding

National Health and Medical Research Council,APP1053206, Mohammed Eslam,APP2001692, Mohammed Eslam,APP1107178, Mohammed Eslam,APP1108422, Mohammed Eslam.

Author information

Authors and Affiliations

  1. Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, NSW, 2145, Australia

    Ziyan Pan & Mohammed Eslam

  2. Gastroenterology and Hepatology Unit, Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman

    Said A. Al-Busafi

  3. Department of Internal Medicine, Ibn Al Nafees Hospital, Manama, 54533, Bahrain

    Maheeba Abdulla

  4. Department of Endemic Medicine and Gastroenterology, Faculty of Medicine, Minia University, Minia, Egypt

    Yasser Fouad

  5. Division of Gastroenterology and Hepatology, Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital, 1001 Blvd. Décarie, Montreal, Canada

    Giada Sebastiani

Authors
  1. Ziyan Pan
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  2. Said A. Al-Busafi
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  3. Maheeba Abdulla
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  4. Yasser Fouad
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  5. Giada Sebastiani
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  6. Mohammed Eslam
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Correspondence to Mohammed Eslam.

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Pan, Z., Al-Busafi, S.A., Abdulla, M. et al. MAFLD identifies patients with significant hepatic fibrosis better than MASLD. Hepatol Int 18, 964–972 (2024). https://doi.org/10.1007/s12072-024-10673-7

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  • DOI: https://doi.org/10.1007/s12072-024-10673-7

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