The Use of Non-i nvasive Biomarkers to Screen for Advanced Fibrosis Associated with Metabolic Dysfunction-associated Steatotic Liver Disease in People with Type 2 Diabetes: A Narrative Review.

TouchREVIEWS in endocrinology Pub Date : 2025-05-01 Epub Date: 2025-02-20 DOI:10.17925/EE.2025.21.1.4
David M Williams, Jagadish Nagaraj, Jeffrey W Stephens, Thinzar Min
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Abstract

There is growing interest in metabolic dysfunction-associated steatotic liver disease (MASLD), given its increasing prevalence and our developing understanding of the disease. People living with type 2 diabetes or obesity have a greater risk of developing significant hepatic steatosis and a greater risk of more rapid progression to steatohepatitis, advanced hepatic fibrosis and hepatocellular carcinoma. As such, various international bodies now advocate for routine screening for MASLD-related hepatic fibrosis in people with such risk factors. This would permit earlier targeted lifestyle interventions and the use of pharmacotherapies, which may reverse earlier stages of MASLD-associated fibrosis. This may improve both liver-related and cardiovascular outcomes in these higher-risk groups. Nonetheless, the identification of MASLD-related hepatic fibrosis is frequently limited to liver enzyme tests, given the lack of a systematic approach to investigation and screening. In this article, we discuss the potential to screen for advanced fibrosis in people with MASLD using various blood-based biomarkers, such as the Fibrosis-4 score, non-alcoholic fatty liver disease fibrosis score and enhanced liver fibrosis test, amongst other available patented and non-patented tests. We discuss the relative benefits and limitations of each and the potential for future research in this evolving area of clinical interest.

使用无创生物标志物筛查2型糖尿病患者与代谢功能障碍相关的脂肪变性肝病相关的晚期纤维化:一项叙述性综述
鉴于代谢功能障碍相关脂肪变性肝病(MASLD)的日益流行和我们对该疾病不断发展的了解,人们对其越来越感兴趣。患有2型糖尿病或肥胖症的人发生显著肝脂肪变性的风险更大,并且更容易迅速发展为脂肪性肝炎、晚期肝纤维化和肝细胞癌。因此,各种国际机构现在提倡对具有这些危险因素的人进行masld相关肝纤维化的常规筛查。这将允许早期有针对性的生活方式干预和药物治疗的使用,这可能会逆转早期的masld相关纤维化。这可能会改善这些高危人群的肝脏相关和心血管预后。尽管如此,由于缺乏系统的调查和筛查方法,masld相关肝纤维化的识别通常仅限于肝酶检测。在本文中,我们讨论了使用各种基于血液的生物标志物筛选MASLD患者晚期纤维化的潜力,如纤维化-4评分、非酒精性脂肪性肝病纤维化评分和增强肝纤维化测试,以及其他可用的专利和非专利测试。我们讨论了每一种的相对益处和局限性,以及在这一不断发展的临床兴趣领域未来研究的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
2.40
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