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Review
. 2024 Sep;13(3):510-531.
doi: 10.1007/s13679-024-00574-z. Epub 2024 May 29.

Non-invasive Scores and Serum Biomarkers for Fatty Liver in the Era of Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD): A Comprehensive Review From NAFLD to MAFLD and MASLD

Farah Abdelhameed  1   2 , Chris Kite  1   3   4   5 , Lukasz Lagojda  1   6 , Alexander Dallaway  1   3 , Kamaljit Kaur Chatha  7   2 , Surinderjeet S Chaggar  8 , Maria Dalamaga  9 , Eva Kassi  9   10 , Ioannis Kyrou  11   12   13   14   15   16   17 , Harpal S Randeva  18   19   20   21
Affiliations
Review

Non-invasive Scores and Serum Biomarkers for Fatty Liver in the Era of Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD): A Comprehensive Review From NAFLD to MAFLD and MASLD

Farah Abdelhameed et al. Curr Obes Rep. 2024 Sep.

Abstract

Purpose of review: The prevalence of non-alcoholic fatty liver disease (NAFLD) is rapidly increasing worldwide, making it the leading cause of liver related morbidity and mortality. Currently, liver biopsy is the gold standard for assessing individuals with steatohepatitis and fibrosis. However, its invasiveness, sampling variability, and impracticality for large-scale screening has driven the search for non-invasive methods for early diagnosis and staging. In this review, we comprehensively summarise the evidence on the diagnostic performance and limitations of existing non-invasive serum biomarkers and scores in the diagnosis and evaluation of steatosis, steatohepatitis, and fibrosis.

Recent findings: Several non-invasive serum biomarkers and scores have been developed over the last decade, although none has successfully been able to replace liver biopsy. The introduction of new NAFLD terminology, namely metabolic dysfunction-associated fatty liver disease (MAFLD) and more recently metabolic dysfunction-associated steatotic liver disease (MASLD), has initiated a debate on the interchangeability of these terminologies. Indeed, there is a need for more research on the variability of the performance of non-invasive serum biomarkers and scores across the diagnostic entities of NAFLD, MAFLD and MASLD. There remains a significant need for finding valid and reliable non-invasive methods for early diagnosis and assessment of steatohepatitis and fibrosis to facilitate prompt risk stratification and management to prevent disease progression and complications. Further exploration of the landscape of MASLD under the newly defined disease subtypes is warranted, with the need for more robust evidence to support the use of commonly used serum scores against the new MASLD criteria and validation of previously developed scores.

Keywords: Biomarkers; Fatty liver; MAFLD; MASLD; Metabolic dysfunction-associated fatty liver disease; Metabolic dysfunction-associated steatotic liver disease; NAFLD; Non-alcoholic fatty liver disease; Obesity.

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Conflict of interest statement

No conflict of interests declared by any of the authors. This research did not involve human participants or animals.

The authors have no competing interests to declare that are relevant to the content of this article.

Figures

Fig.1
Fig.1
Summary of the diagnostic criteria for NAFLD, MAFLD and MASLD [, ••, ••]
Fig.2
Fig.2
Current diagnostic criteria for metabolic syndrome according to the 2009 joint statement of the International Diabetes Federation Task Force on Epidemiology and Prevention, the National Heart, Lung, and Blood Institute the American Heart Association, the World Heart Federation, the International Atherosclerosis Society, and the International Association for the Study of Obesity [24, 25]
Fig.3
Fig.3
A suggested simplified algorithm for the use of non-invasive serum biomarker scores for the assessment of patients across the three diagnostic entities of steatotic liver disease (NAFLD/MAFLD/MASLD) [6, 91]
Fig.4
Fig.4
Framework for the multi-omics integration for personalised management of NAFLD/MAFLD/MASLD [••]
See this image and copyright information in PMC

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