Longitudinal Changes in Fibrosis Markers: Monitoring Stiffness/Fibrosis Progression and Prognostic Outcomes in MASLD

Xiao-Dong Zhou¹, Yu-Ting Li², Seung Up Kim³, Terry Cheuk-Fung Yip⁴, Salvatore Petta⁵, Atsushi Nakajima⁶, Emmanuel Tsochatzis⁷, Junping Shi⁸, Wah-Kheong Chan⁹, Jérôme Boursier¹⁰, Elisabetta Bugianesi¹¹, Yusuf Yilmaz¹², Hannes Hagström¹³, Manuel Romero-Gomez¹⁴, Khalid Alswat¹⁵, José Luis Calleja¹⁶, Hirokazu Takahashi¹⁷, Victor de Lédinghen¹⁸, Shalimar¹⁹, Laurent Castéra²⁰, Arun J Sanyal²¹, George Boon-Bee Goh²², Philip N Newsome²³, Jian-Gao Fan²⁴, Michelle Lai²⁵, Sandeep Aggarwal²⁶, Stergios Kechagias²⁷, Yoichi Hiasa²⁸, Zhongtao Zhang²⁹, Jacob George³⁰, Mohamed El-Kassas³¹, Jinjun Chen³², Hong You³³, Barham K Abu Dayyeh³⁴, Huiping Sheng³⁵, Leon A Adams³⁶, Jing Wang³⁷, Fangping He³⁸, Huiqing Liang³⁹, Yong-Feng Yang⁴⁰, Xiaoling Chi⁴¹, Bihui Zhong⁴², Yan Bi⁴³, Yuqiang Mi⁴⁴, Yongfen Zhu⁴⁵, Rixing Bai⁴⁶, Jing Zhang⁴⁷, Bingyuan Wang⁴⁸, Jinghai Song⁴⁹, Hong Deng⁵⁰, Qing Xie⁵¹, Lang Bai⁵², Yongning Xin⁵³, Wen Xie⁵⁴, Jie Li⁵⁵, Céline Fournier-Poizat¹⁸, Chutian Wu⁵⁶, Hye Won Lee³, Grace Lai-Hung Wong⁵⁷, Angelo Armandi¹¹, Ying Shang⁵⁸, Grazia Pennisi⁵, Elba Llop¹⁶, Masato Yoneda⁶, Marc de Saint-Loup¹⁰, Carmen Lara-Romero¹⁴, Rocio Gallego-Durán¹⁴, Amon Asgharpour²¹, Kevin Kim-Jun Teh²², Mandy Sau-Wai Chan¹⁸, Huapeng Lin⁵⁹, Wen-Yue Liu⁶⁰, Sherlot Juan Song⁵⁷, Waleed K Al-Hamoudi¹⁵, Hiroshi Isoda⁶¹, Teruki Miyake²⁸, Sanjaya K Satapathy⁶², Mengyi Li²⁹, Keshni Sharma³⁰, Mohammed Emadeldeen⁶³, Ling Zhou³², Xiaofei Tong³³, Fateh Bazerbachi⁶⁴, Xiaotang Fan³⁸, Huanming Xiao⁴¹, Junzhao Ye⁴², Liang Xu⁴⁴, Xiaolin Wang⁵¹, Yi-Xuan Wei¹, Mirko Zoncape⁷, Wenhao Li⁶⁵, Vincent Wai-Sun Wong⁶⁶, Ming-Hua Zheng⁶⁷; VCTE-Prognosis Study Group; Paired Liver Biopsy Group

Collaborators, Affiliations

Collaborators

VCTE-Prognosis Study Group:
Arun J Sanyal, Atsushi Nakajima, Elisabetta Bugianesi, Emmanuel Tsochatzis, George Boon-Bee Goh, Hannes Hagström, Jérôme Boursier, José Luis Calleja, Manuel Romero-Gomez, Ming-Hua Zheng, Philip N Newsome, Salvatore Petta, Seung Up Kim, Victor de Lédinghen, Vincent Wai-Sun Wong, Wah-Kheong Chan
Paired Liver Biopsy Group:
Barham K Abu Dayyeh, Bihui Zhong, Bingyuan Wang, Chutian Wu, Fangping He, Hirokazu Takahashi, Hong Deng, Hong You, Huiping Sheng, Huiqing Liang, Jacob George, Jie Li, Jing Wang, Jing Zhang, Jinghai Song, Jinjun Chen, Junping Shi, Jérôme Boursier, Khalid Alswat, Lang Bai, Leon A Adams, Ming-Hua Zheng, Mohamed El-Kassas, Qing Xie, Rixing Bai, Salvatore Petta, Sandeep Aggarwal, Sanjaya K Satapathy, Shalimar, Stergios Kechagias, Vincent Wai-Sun Wong, Wah-Kheong Chan, Wen Xie, Xiaoling Chi, Yan Bi, Yoichi Hiasa, Yongfen Zhu, Yong-Feng Yang, Yongning Xin, Yuqiang Mi, Yusuf Yilmaz, Zhongtao Zhang

Affiliations

¹ MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
² MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Translational Medicine Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
³ Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁴ Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
⁵ Section of Gastroenterology, PROMISE, University of Palermo, Italy.
⁶ Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
⁷ University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom.
⁸ Department of Hepatology, Hangzhou Normal University Affiliated Hospital, Hangzhou, China.
⁹ Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
¹⁰ Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France.
¹¹ Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.
¹² Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.
¹³ Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden; Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden.
¹⁴ Digestive Diseases Unit and CIBERehd, Virgen Del Rocío University Hospital, Seville, Spain.
¹⁵ Liver Disease Research Center, Department of Medicine, College of Medicine, King Saudi University, Riyadh, Saudi Arabia.
¹⁶ Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
¹⁷ Liver Center, Saga University Hospital, Saga, Japan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
¹⁸ Echosens, Paris, France.
¹⁹ Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Delhi, India.
²⁰ Université Paris Cité, UMR1149 (CRI), INSERM, Paris, France; Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Clichy, France.
²¹ Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
²² Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
²³ Roger Williams Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Foundation for Liver Research and King's College Hospital, London, United Kingdom.
²⁴ Department of Gastroenterology and Hepatology, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
²⁵ Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
²⁶ Institute of Minimal Access, Bariatric, GI, and Robotic Surgery, Manipal Hospitals, Dwarka, New Delhi, India.
²⁷ Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Gastroenterology and Hepatology, University Hospital, Linköping, Sweden.
²⁸ Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
²⁹ Department of General Surgery, Beijing Friendship Hospital, Capital Medical University and National Clinical Research Center for Digestive Diseases and State Key Lab of Digestive Health, Beijing, China.
³⁰ Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia.
³¹ Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt; Steatotic Liver Disease Study Foundation in Middle East and North Africa (SLMENA), Cairo, Egypt.
³² Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Hepatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangzhou, China; Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China.
³³ Liver Research Center, Beijing Friendship Hospital, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Capital Medical University, Beijing, China.
³⁴ Division of Gastroenterology and Hepatology, Cedar Sinai Medical Center, Los Angeles, California.
³⁵ Department of Infectious Diseases, General Hospital of Ningxia Medical University, Ningxia, China.
³⁶ Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia.
³⁷ Department of Hepatobiliary Disease, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China.
³⁸ Department of Hepatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
³⁹ Hepatology Unit, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China.
⁴⁰ Department of Liver Disease, the Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.
⁴¹ Department of Hepatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
⁴² Department of Gastroenterology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
⁴³ Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
⁴⁴ Department of Hepatology, Clinical School of the Second People's Hospital, Tianjin Institute of Hepatology, Tianjin Medical University, Tianjin, China.
⁴⁵ Department of Hepatology and Infection, Sir Run Run Shaw Hospital, Affiliated with School of Medicine, Zhejiang University, Hangzhou, China.
⁴⁶ Department of General Surgery, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
⁴⁷ Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
⁴⁸ Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, China.
⁴⁹ Department of General Surgery, Beijing Hospital, National Center of Gerontology, Beijing, China.
⁵⁰ Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
⁵¹ Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵² Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
⁵³ Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
⁵⁴ Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
⁵⁵ Department of Infectious Disease, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
⁵⁶ Department of Gastroenterology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangdong, China.
⁵⁷ Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
⁵⁸ Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
⁵⁹ Department of Gastroenterology and Hepatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Center for Digestive Diseases Research and Clinical Translation of Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Gut Microecology and Associated Major Diseases Research, Shanghai, China.
⁶⁰ Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
⁶¹ Liver Center, Saga University Hospital, Saga, Japan.
⁶² Department of Medicine, North Shore University Hospital/Northwell Health, Manhasset, New York; Northwell Health Center for Liver Diseases & Transplantation, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra, Hempstead Tpke, Hempstead, New York.
⁶³ Gastroenterology and Hepatology Department, National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
⁶⁴ Centracare, Interventional Endoscopy Program, St Cloud, Minnesota; Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota.
⁶⁵ Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, United Kingdom.
⁶⁶ Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: wongv@cuhk.edu.hk.
⁶⁷ MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Institute of Hepatology, Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China. Electronic address: zhengmh@wmu.edu.cn.

PMID: 40714381
DOI: 10.1016/j.cgh.2025.07.011

Longitudinal Changes in Fibrosis Markers: Monitoring Stiffness/Fibrosis Progression and Prognostic Outcomes in MASLD

Xiao-Dong Zhou et al. Clin Gastroenterol Hepatol. 2025.

. 2025 Jul 24:S1542-3565(25)00622-6.

doi: 10.1016/j.cgh.2025.07.011. Online ahead of print.

Authors

Collaborators

VCTE-Prognosis Study Group:
Arun J Sanyal, Atsushi Nakajima, Elisabetta Bugianesi, Emmanuel Tsochatzis, George Boon-Bee Goh, Hannes Hagström, Jérôme Boursier, José Luis Calleja, Manuel Romero-Gomez, Ming-Hua Zheng, Philip N Newsome, Salvatore Petta, Seung Up Kim, Victor de Lédinghen, Vincent Wai-Sun Wong, Wah-Kheong Chan
Paired Liver Biopsy Group:
Barham K Abu Dayyeh, Bihui Zhong, Bingyuan Wang, Chutian Wu, Fangping He, Hirokazu Takahashi, Hong Deng, Hong You, Huiping Sheng, Huiqing Liang, Jacob George, Jie Li, Jing Wang, Jing Zhang, Jinghai Song, Jinjun Chen, Junping Shi, Jérôme Boursier, Khalid Alswat, Lang Bai, Leon A Adams, Ming-Hua Zheng, Mohamed El-Kassas, Qing Xie, Rixing Bai, Salvatore Petta, Sandeep Aggarwal, Sanjaya K Satapathy, Shalimar, Stergios Kechagias, Vincent Wai-Sun Wong, Wah-Kheong Chan, Wen Xie, Xiaoling Chi, Yan Bi, Yoichi Hiasa, Yongfen Zhu, Yong-Feng Yang, Yongning Xin, Yuqiang Mi, Yusuf Yilmaz, Zhongtao Zhang

Affiliations

¹ MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
² MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Translational Medicine Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
³ Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁴ Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
⁵ Section of Gastroenterology, PROMISE, University of Palermo, Italy.
⁶ Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
⁷ University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom.
⁸ Department of Hepatology, Hangzhou Normal University Affiliated Hospital, Hangzhou, China.
⁹ Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
¹⁰ Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France.
¹¹ Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.
¹² Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.
¹³ Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden; Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden.
¹⁴ Digestive Diseases Unit and CIBERehd, Virgen Del Rocío University Hospital, Seville, Spain.
¹⁵ Liver Disease Research Center, Department of Medicine, College of Medicine, King Saudi University, Riyadh, Saudi Arabia.
¹⁶ Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
¹⁷ Liver Center, Saga University Hospital, Saga, Japan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
¹⁸ Echosens, Paris, France.
¹⁹ Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Delhi, India.
²⁰ Université Paris Cité, UMR1149 (CRI), INSERM, Paris, France; Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Clichy, France.
²¹ Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
²² Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
²³ Roger Williams Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Foundation for Liver Research and King's College Hospital, London, United Kingdom.
²⁴ Department of Gastroenterology and Hepatology, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
²⁵ Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
²⁶ Institute of Minimal Access, Bariatric, GI, and Robotic Surgery, Manipal Hospitals, Dwarka, New Delhi, India.
²⁷ Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Gastroenterology and Hepatology, University Hospital, Linköping, Sweden.
²⁸ Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
²⁹ Department of General Surgery, Beijing Friendship Hospital, Capital Medical University and National Clinical Research Center for Digestive Diseases and State Key Lab of Digestive Health, Beijing, China.
³⁰ Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia.
³¹ Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt; Steatotic Liver Disease Study Foundation in Middle East and North Africa (SLMENA), Cairo, Egypt.
³² Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Hepatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangzhou, China; Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China.
³³ Liver Research Center, Beijing Friendship Hospital, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Capital Medical University, Beijing, China.
³⁴ Division of Gastroenterology and Hepatology, Cedar Sinai Medical Center, Los Angeles, California.
³⁵ Department of Infectious Diseases, General Hospital of Ningxia Medical University, Ningxia, China.
³⁶ Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia.
³⁷ Department of Hepatobiliary Disease, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China.
³⁸ Department of Hepatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
³⁹ Hepatology Unit, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China.
⁴⁰ Department of Liver Disease, the Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.
⁴¹ Department of Hepatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
⁴² Department of Gastroenterology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
⁴³ Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
⁴⁴ Department of Hepatology, Clinical School of the Second People's Hospital, Tianjin Institute of Hepatology, Tianjin Medical University, Tianjin, China.
⁴⁵ Department of Hepatology and Infection, Sir Run Run Shaw Hospital, Affiliated with School of Medicine, Zhejiang University, Hangzhou, China.
⁴⁶ Department of General Surgery, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
⁴⁷ Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
⁴⁸ Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, China.
⁴⁹ Department of General Surgery, Beijing Hospital, National Center of Gerontology, Beijing, China.
⁵⁰ Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
⁵¹ Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵² Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
⁵³ Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
⁵⁴ Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
⁵⁵ Department of Infectious Disease, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
⁵⁶ Department of Gastroenterology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangdong, China.
⁵⁷ Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
⁵⁸ Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
⁵⁹ Department of Gastroenterology and Hepatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Center for Digestive Diseases Research and Clinical Translation of Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Gut Microecology and Associated Major Diseases Research, Shanghai, China.
⁶⁰ Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
⁶¹ Liver Center, Saga University Hospital, Saga, Japan.
⁶² Department of Medicine, North Shore University Hospital/Northwell Health, Manhasset, New York; Northwell Health Center for Liver Diseases & Transplantation, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra, Hempstead Tpke, Hempstead, New York.
⁶³ Gastroenterology and Hepatology Department, National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
⁶⁴ Centracare, Interventional Endoscopy Program, St Cloud, Minnesota; Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota.
⁶⁵ Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, United Kingdom.
⁶⁶ Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: wongv@cuhk.edu.hk.
⁶⁷ MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Institute of Hepatology, Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China. Electronic address: zhengmh@wmu.edu.cn.

PMID: 40714381
DOI: 10.1016/j.cgh.2025.07.011

Abstract

Background & aims: Fibrosis-4 Index (FIB-4) is a noninvasive tool for assessing liver fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD). However, its role of dynamic FIB-4 for assessing fibrosis progression and predicting clinical outcomes remains unclear. The aim of this study was to examine the association between changes in FIB-4 and changes in liver stiffness, fibrosis progression, and outcomes in MASLD.

Methods: Three cohorts were analyzed: VCTE-Prognosis cohort (n = 10,203) for stiffness progression, Paired Liver Biopsy cohort (n = 1,145) for fibrosis progression, and Wenzhou Real-World (WRW) cohort (n = 41,105) for clinical outcomes. Stiffness progression was defined as an increase in liver stiffness measurement, and fibrosis progression by a 1-stage increase. Outcomes included all-cause mortality, cardiovascular events, and liver-related events (LREs). FIB-4 was dichotomized into low (<1.3) and high (≥1.3). Increases were defined as ≥20% rise and to ≥1.3 in the low FIB-4 group, and ≥20% rise in the high FIB-4 group.

Results: In the VCTE-Prognosis cohort, stiffness progression was more likely with increasing vs stable FIB-4 (adjusted odds ratio [OR], 2.36; P < .001) in those with low baseline FIB-4. In the high FIB-4 group, stiffness progression rates increased from stable to increasing FIB-4 (adjusted OR, 3.42; P < .001). In the Paired Liver Biopsy cohort, fibrosis progression was more frequent with increasing FIB-4 (adjusted OR, 2.20; P = .004 in low FIB-4; adjusted OR, 3.68; P < .001 in high FIB-4). In the WRW cohort, an increase in dynamic FIB-4 was linked to higher risks for all-cause mortality, cardiovascular events, and LREs (all P < .001).

Conclusions: Dynamic FIB-4 monitoring tracks fibrosis and stiffness progression and predicts clinical outcomes in MASLD.

Keywords: Fibrosis; Fibrosis-4 Index; Liver Cirrhosis; Metabolic Dysfunction-associated Steatotic Liver Disease; Prognosis.

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Longitudinal Changes in Fibrosis Markers: Monitoring Stiffness/Fibrosis Progression and Prognostic Outcomes in MASLD

Collaborators

Affiliations

Longitudinal Changes in Fibrosis Markers: Monitoring Stiffness/Fibrosis Progression and Prognostic Outcomes in MASLD

Authors

Collaborators

Affiliations

Abstract

LinkOut - more resources

Full Text Sources