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, Chris Kite, Lukasz Lagojda, Alexander Dallaway, Kamaljit Kaur Chatha, Surinderjeet S. Chaggar, Maria Dalamaga, Eva Kassi, Ioannis Kyrou*, Harpal S. Randeva*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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. Summary: 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.
Original languageEnglish
Pages (from-to)510-531
Number of pages22
JournalCurrent Obesity Reports
Volume13
Issue number3
Early online date29 May 2024
DOIs
Publication statusPublished - 1 Sept 2024

Bibliographical note

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License

© 2024. The Author(s).

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
  • Humans
  • Liver Cirrhosis/blood
  • Liver/pathology
  • Fatty Liver/blood
  • Biopsy
  • Biomarkers/blood
  • Non-alcoholic Fatty Liver Disease/blood

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