Comments on validation of conventional non-invasive fibrosis scoring systems in patients with metabolic associated fatty liver disease

Abstract

To evaluate and predict liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD), several non-invasive scoring systems were built and widely used in the progress of diagnosis and treatment, which showed great diagnostic efficiency, such as aspartate aminotransferase to platelet ratio index, fibrosis-4 index, body mass index, aspartate aminotransferase to alanine aminotransferase ratio, diabetes score and NAFLD fibrosis score. Since the new concept of metabolic associated fatty liver disease (MAFLD) was proposed, the clinical application value of the non-invasive scoring systems mentioned above has not been assessed in MAFLD. The evaluation of the diagnostic performance of these non-invasive scoring systems will provide references for clinicians in the diagnosis of MAFLD.

Keywords: Metabolic associated fatty liver disease; Prediction model; Calibration; Normal distribution; Nonalcoholic fatty liver disease

Core Tip: The concept of metabolic associated fatty liver disease (MAFLD) was proposed in 2020. Unlike the concept of nonalcoholic fatty liver disease, the exclusion of chronic liver disease was not required in the establishment of diagnosis of MAFLD, but the presence of metabolic associated disease or dysfunction is required. The clinical prediction values and the optimal cutoff values of non-invasive fibrosis scores remain unknown. We read the recent article entitled “Validation of Conventional Non-invasive Fibrosis Scoring Systems in Patients with Metabolic Associated Fatty Liver Disease” with great interest. We would like to share our opinions and criticisms about this valuable work.