This multicenter cross-sectional study evaluated the diagnostic performance of non-invasive tests (NITs) in detecting metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis among 124 biopsy-confirmed patients with MASLD, all over 50 years old and living with overweight/obesity and type 2 diabetes. Researchers tested a range of NITs—including vibration-controlled transient elastography, FIB-4, NFS, the OWLiver Panel, MASEF, and FibroScan-AST—analyzing their sensitivity, specificity, predictive values, and AUC to determine their effectiveness both individually and in combination.

The OWLiver Panel accurately classified 86.1% of patients with MASH, achieving high sensitivity (0.86) and PPV (0.85), but low specificity and NPV. Its performance remained consistent regardless of gender, obesity class, or diabetes control. Most NITs showed good diagnostic performance for at-risk MASH (AUC > 0.70), except for NFS. MASEF emerged as the most reliable test for identifying both at-risk MASH and advanced fibrosis, with AUCs of 0.77 and 0.80, respectively, and the highest NPV (92%) for advanced fibrosis. Combining multiple NITs offered no significant advantage over using MASEF alone, suggesting that a one-step strategy using the OWLiver Panel or MASEF may be effective for screening high-risk patients with MASLD.

Reference: Iruzubieta P, Mayo R, Mincholé I, et al. One-step non-invasive diagnosis of metabolic dysfunction-associated steatohepatitis and fibrosis in high-risk population. United European Gastroenterol J. 2024 Sep;12(7):919-929. doi: 10.1002/ueg2.12589. Epub 2024 Aug 4. PMID: 39099245; PMCID: PMC11497651.