The Accuracy of MAFLD Fibrosis Score in non-Invasive Assessment of Liver Fibrosis and Fibrotic NASH in MAFLD Egyptian Patients

Abstract

Background and study aim: Fibrotic non-alcoholic steatohepatitis (NASH), a clinically significant form of metabolic dysfunction-associated fatty liver disease (MAFLD) characterized by liver fibrosis, requires prompt identification to enable early therapeutic intervention. Existing non-invasive scores show limited accuracy across populations, including the Fibrosis-4 index (FIB-4), the aspartate aminotransferase-to-platelet ratio index (APRI), and the non-alcoholic fatty liver disease (NAFLD) Fibrosis Score (NFS), compared to the MAFLD Fibrosis Score (MFS). This research sought to determine how well the MFS could diagnose significant fibrosis and fibrotic NASH.Patients and Methods: a total of 382 Egyptian patients diagnosed with NAFLD were included in this cross-sectional analysis. The fibroscan-aspartate aminotransferase (FAST) score and liver stiffness measurement (LSM) were used to categorize the participants; fibrotic NASH was regarded as having a threshold of ≥0.67. Clinical parameters and fibrosis scores were calculated and compared.Results: Significant fibrosis (≥F2) was found in 19.6% of cases, while fibrotic NASH was present in 6.02%. MFS had the greatest AUC (0.737) for significant fibrosis and at a threshold of >13.75 it predicted significant fibrosis with a sensitivity of 66.7% and a specificity of 67.75%. For fibrotic NASH, MFS showed a high specificity (94.4%) and positive predictive value (90.8%) at a cutoff of >15.98, ranking third after APRI and FIB-4.Conclusion: MFS is a promising non-intrusive model to detect significant fibrosis and fibrotic NASH and may enhance early diagnosis when combined with other markers.