Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 1;25(1):454.
doi: 10.1186/s12876-025-03992-y.

Prevalence of advanced liver fibrosis in the general population of the Paris region according to FIB-4 score and liver risk score

Henri Tran  1 , Stefano Caruso  1 , Anne-Laure Mazialivoua  1 , Cecile Fargeat  2 , Odile Rousselet  2 , Adrien Ko  2 , Vincent Leroy  1 , Patrick Ingiliz  3
Affiliations

Prevalence of advanced liver fibrosis in the general population of the Paris region according to FIB-4 score and liver risk score

Henri Tran et al. BMC Gastroenterol. .

Abstract

Background and aims: The ideal non-invasive marker to identify patient at risk for liver fibrosis in the general population is unknown. Current guidelines (EASL) recommend using the FIB-4 score as a screening tool but the low specificity may result in a large number of potentially false-positive results. Recently, the liver risk score (LRS) has been suggested to more accurately identify patients at-risk. The aim of our study was to identify populations at-risk using the two scores.

Materials and methods: “Cerbafib” was a prospective cohort derived from laboratories throughout the Paris region. The prevalence of advanced liver fibrosis was assessed using the non-invasive FIB-4 score with a cut-off of 2.67 (rule-in) and 1.3 (rule-out) and the LRS with a cut-off of < 6 (minimal risk), ≥ 6 to < 10 (low risk), ≥ 10 to < 15 (medium risk) and ≥ 15 (high risk).

Results: Between January and April 2023, 179 865 patients were included in the cohort. The mean age was 52 years and 45% were men. FIB-4 identified 55 376 (31%) patients requiring specialist referral ( ≥ = 1.3) and 4002 patients (2.2%) with suspected advanced fibrosis. LRS identified 38 175 (21%) patients with estimated liver stiffness ≥ 6 kPa, 1 933 patients (1%) ≥ 10 kPa and 35 (0.02%) patients ≥ 15 kPa. There was a poor correlation between the two tests (r = 0.45).

Conclusion: The Liver Risk Score is a practical tool to identify a population in need of further hepatologic evaluation. Compared to FIB-4, the population identified by LRS is smaller and different. An adapted new pragmatic screening algorithm using LRS should be considered.

Keywords: Cirrhosis; Fibroscan (R); Liver-relates mortality; Non-invasive test; Screening.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the IRB ethics committee at Henri Mondor University Hospital (n° 00011558). All patients gave written informed consent for the use and the publication of their clinical data. The study was conducted in compliance with the Declaration of Helsinki. Consent for publication: NA. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart. AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, gamma-glutamyl transferase
Fig. 2
Fig. 2
Correlation between FIB-4 score and LRS
Fig. 3
Fig. 3
Proposed screening strategy using the LRS. MASLD, metabolic-dysfunction associated steatotic liver disease; MetALD, metabolic-dysfunction associated alcoholic liver disease
See this image and copyright information in PMC

References

    1. Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol. 2019;70(1):151–71. - PubMed
    1. Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, Kamath PS. Liver cirrhosis. Lancet 9 Oct. 2021;398(10308):1359–76. - PubMed
    1. Rinella ME, Lazarus JV, Ratziu V, Francque SM, Sanyal AJ, Kanwal F, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatol Déc. 2023;78(6):1966. - PMC - PubMed
    1. Gofton C, Upendran Y, Zheng MH, George J. MAFLD: how is it different from NAFLD? Clin Mol Hepatol Févr. 2023;29(Suppl):S17–31. - PMC - PubMed
    1. Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84. - PubMed

LinkOut - more resources