Early identification of patients with a NAFLD activity score ≥4 and significant fibrosis (≥F2) is crucial, as these individuals are at increased risk for disease progression and may benefit from timely interventions. To improve diagnosis, researchers developed the MASEF score, a metabolomics-based tool that incorporates 12 lipids, BMI, AST, and ALT levels, to identify patients with at-risk metabolic dysfunction-associated steatohepatitis (MASH). The MASEF score was tested in both derivation (n=790) and validation (n=565) cohorts and compared to the existing FibroScan-AST (FAST) score and liver stiffness measurements (LSM) by vibration-controlled transient elastography (VCTE).

The MASEF score demonstrated strong diagnostic performance, with an area under the receiver-operating characteristic curve (AUC) of 0.76 in the derivation cohort and 0.79 in the validation cohort. It showed similar sensitivity and specificity compared to the FAST score and FIB-4+LSM by VCTE. Given its performance, MASEF could serve as a valuable alternative to LSM by VCTE for assessing at-risk MASH, potentially providing clinicians with an additional non-invasive diagnostic option to improve early detection and management of the disease.

Reference: Noureddin M, Truong E, Mayo R, et al. Serum identification of at-risk MASH: The metabolomics-advanced steatohepatitis fibrosis score (MASEF). Hepatology. 2024 Jan 1;79(1):135-148. doi: 10.1097/HEP.0000000000000542. Epub 2023 Jul 24. PMID: 37505221; PMCID: PMC10718221.