Li T, Wang X, Nie M, Han Q, Wu XY, Mao JF. Fibrosis index nine superiority for cirrhosis in hypopituitarism: Clinical validation of endocrine liver triage tool. World J Gastroenterol 2026; 32(28): 119442 [DOI: 10.3748/wjg.119442]
Corresponding Author of This Article
Jiang-Feng Mao, MD, Professor, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. maojf@pumch.cn
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Gastroenterology & Hepatology
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Li T, Wang X, Nie M, Han Q, Wu XY, Mao JF. Fibrosis index nine superiority for cirrhosis in hypopituitarism: Clinical validation of endocrine liver triage tool. World J Gastroenterol 2026; 32(28): 119442 [DOI: 10.3748/wjg.119442]
World J Gastroenterol. Jul 28, 2026; 32(28): 119442 Published online Jul 28, 2026. doi: 10.3748/wjg.119442
Fibrosis index nine superiority for cirrhosis in hypopituitarism: Clinical validation of endocrine liver triage tool
Ting Li, Xi Wang, Min Nie, Qin Han, Xue-Yan Wu, Jiang-Feng Mao
Ting Li, Xi Wang, Min Nie, Xue-Yan Wu, Jiang-Feng Mao, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Qin Han, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
Co-first authors: Ting Li and Xi Wang.
Co-corresponding authors: Xue-Yan Wu and Jiang-Feng Mao.
Author contributions: Li T and Wang X contributed equally to this study as co-first authors; Mao JF and Wu XY contributed equally to this study as co-corresponding authors; Mao JF conceived the study concept; Li T and Wang X designed the research protocol; Li T, Wang X, Nie M, Wu XY, and Mao JF performed data collection and analysis; Li T drafted the manuscript; Wang X, Nie M, Han Q, Wu XY, and Mao JF critically revised the manuscript for important intellectual content; and all authors read and approved the final version of the manuscript.
Institutional review board statement: Ethical approval for this study was obtained from the Ethics Committee of Peking Union Medical College Hospital (Approval No. I-23PJ1809), with approval number K4892, ensuring that all research activities were conducted in accordance with ethical principles and standards.
Informed consent statement: This study only involves anonymous and routine clinical data, it does not involve additional patient contact or intervention, so according to the guidelines of the institutional review committee, informed consent is not required.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Data sharing statement: The aggregated data supporting the findings of this study are included in the manuscript and its tables/figures. The fully anonymized individual participant dataset is available from the corresponding authors upon reasonable request.
Corresponding author: Jiang-Feng Mao, MD, Professor, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. maojf@pumch.cn
Received: January 28, 2026 Revised: March 19, 2026 Accepted: April 2, 2026 Published online: July 28, 2026 Processing time: 165 Days and 20.7 Hours
Core Tip
Core Tip: Patients with hypopituitarism are at high risk for rapidly progressive metabolic liver disease, yet traditional non-invasive tests often lack accuracy in this specific endocrine-mediated context. This study provides the first clinical validation of the fibrosis-9 (FIB-9) index in hypopituitary patients. Our findings reveal that FIB-9 (area under the receiver operating characteristic curve = 0.941) significantly outperforms aspartate aminotransferase-to-platelet ratio index, fibrosis-4, and conventional serum markers in identifying cirrhosis. Using an optimal cutoff of 1.748, FIB-9 serves as a highly reliable triage tool, enabling clinicians to accurately identify high-risk patients for advanced liver assessment while sparing others from unnecessary testing.
