부산대학교 도서관

Summary: Background: Non‐invasive assessment of fibrosis is predictive of the prognosis of non‐alcoholic and alcoholic fatty liver disease but this has not been demonstrated in metabolic (dysfunction)‐associated fatty liver disease (MAFLD). Aims: We assessed the prognosis of non‐invasive methods in patients with MAFLD. Methods: All consecutive patients with MAFLD, with liver stiffness measurements, FIB‐4 (Fibrosis‐4), and LIVERFASt were included in this cohort study. The primary endpoint was analysed by the Kaplan‐Meier method and secondary endpoints were estimated by Gray test or logistic regression. Factors independently associated with overall mortality and morbidity were identified by a multivariate Cox model. The prognostic performance of non‐invasive methods for prediction of mortality was evaluated by Harrell's C‐index and for morbidity by area under the receiver operating characteristics curve (AUC). Results: A total of 1239 patients with MAFLD were analysed (median age 56 years, male 56.5%, median body mass index 31 kg/m2 and obesity 59%). The median follow‐up was 62 months [42‐91 months] and 73 (5.8%) subjects died. Baseline results of non‐invasive methods were correlated with overall and liver‐related mortalities (P < 0.001), and with all‐cause and liver‐related outcomes (P < 0.001). A predictive model (composed of clinical parameters and liver stiffness measurement, FIB‐4 or LIVERFASt) was an excellent predictor of overall and liver‐related mortalities (C‐index 0.8‐0.9), and a good predictor of overall and liver‐related morbidities (AUC 0.72‐0.74). Conclusion: Baseline liver stiffness measurement, FIB‐4 and LIVERFASt can predict global and liver‐related mortality and morbidity in patients with MAFLD and could be prognosis endpoints in clinical trials. [ABSTRACT FROM AUTHOR]