Prediction model for the development of liver fibrosis in patients with metabolic dysfunction–associated steatotic liver disease
Authors: Krolevets T.S. ,   Siberian State Medical University, Tomsk, Russian Federation, Livzan M.A. , Syrovenko M.I. , Shcherbakova L.V. ,   Omsk State Medical University, Omsk, Russian Federation,   Omsk State Medical University, Omsk, Russian Federation,   Research Institute of Therapy and Preventive Medicine — Branch of the Institute of Cytology and Genetics of the Siberian Branch of the RAS, Novosibirsk, Russian Federation
Published: July 2024

Aim: to reduce the risk of progression of hepatic complications of non-alcoholic fatty liver disease (NAFLD) (or metabolic dysfunction– associated steatotic liver disease (MASLD)) by developing a clinical and laboratory prognostic model of liver fibrosis. Patients and Methods: this comparative study included 288 patients with NAFLD (MASLD) (158 men and 130 women) with a mean age of 50.9±10.8 years. All patients underwent standard clinical and laboratory examination, abdominal ultrasound, and transient elastography with CAP. The data obtained were analyzed in groups based on fibrosis stage (0-3) using comparative methods, simple and multiple logistic regression. Results: patients with NAFLD (MASLD) and liver fibrosis had a significantly longer medical history (18 (12-48) months without fibrosis and 24 (12-60) months with fibrosis). The most common comorbidities were gallstone disease, hypertension, type 2 diabetes (T2D), prediabetes, dyslipidemia, and chronic metabolic pancreatitis. Waist circumference (WC) tended to increase with fibrosis, i.e., median WC was 102.5 (99.7-110) cm in patients with F0, 105 (100-112) cm in patients with F1, and 108 (100-116) cm in patients with F2 and F3. Regression analysis showed that age, gender, WC, total cholesterol level, presence of non-alcoholic steatohepatitis (NASH), cholelithiasis and T2D had a significant independent effect on the risk of liver fibrosis. The risk of developing fibrosis increased by 2% with each 1-year increase in age (odds ratio (OR) 1.017, 95% confidence interval (CI) 0.989-1.046); by 2-fold in men (OR 2.086, 95% CI 1.123-3.872); by 2.8-fold in men with WC >102 cm and in women with WC >88 cm (OR 2.766, 95% CI 1.300-5. 887); by 1.9-fold in total cholesterol levels >5.2 mmol/l regardless of statin use (OR 1.867, 95% CI 1.073-3.248); by 2.7-fold in NASH (OR 2.729, 95% CI 1.556-4.784); by 4.5-fold in T2D (OR 4.527, 95% CI 1.715-11.946); and by 2-fold in gallstone disease (OR 2.160, 95% CI 1.355-4.033). Conclusions: age, gender, WC, total cholesterol, NASH, gallstone disease and T2D significantly independently influence the risk of liver fibrosis. The developed model with sensitivity of 82.7% and specificity of 50.9% helps to identify individuals with high risk of liver fibrosis stage progression among patients with MASLD. KEYWORDS: nonalcoholic fatty liver disease, fibrosis, clinical and laboratory markers, prognosis, predictors. FOR CITATION: Krolevets T.S., Livzan M.A., Syrovenko M.I., Shcherbakova L.V. Prediction model for the development of liver fibrosis in patients with metabolic dysfunction–associated steatotic liver disease. Russian Medical Inquiry. 2024;8(5):243–252 (in Russ.). DOI: 10.32364/2587-6821-2024-8-5-1.