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<p>Given the high prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and the limitations of liver biopsy, there is a&#xa0;great need for validated and cost-effective biomarkers. Disease activity and fibrosis stage can be estimated in daily clinical practice using simple scores. The FIB‑4 index is currently used in guidelines as an estimator for risk stratification. Additionally, serum-based markers of the extracellular matrix and collagen turnover are available. The goal is to identify and treat advanced, precirrhotic stages to prevent terminal complications. Besides blood-based biomarkers, imaging methods such as elastography and magnetic resonance imaging-based techniques are available and used either alone or in combination with serum biomarkers. In the future, these noninvasive biomarkers will also be used as surrogate endpoints in therapy studies and to predict the benefit of drug therapies. The discussed biomarkers already allow identification of people requiring treatment and will play a&#xa0;crucial role in the personalized care of people with MASLD.</p>

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Rationale Diagnostik bei metabolischen Lebererkrankungen (MASLD)

  • 期刊论文

  • 发表日期：

    2026年3月30日

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  • Alexander Barton,
  • Jörn M. Schattenberg

摘要

Given the high prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and the limitations of liver biopsy, there is a great need for validated and cost-effective biomarkers. Disease activity and fibrosis stage can be estimated in daily clinical practice using simple scores. The FIB‑4 index is currently used in guidelines as an estimator for risk stratification. Additionally, serum-based markers of the extracellular matrix and collagen turnover are available. The goal is to identify and treat advanced, precirrhotic stages to prevent terminal complications. Besides blood-based biomarkers, imaging methods such as elastography and magnetic resonance imaging-based techniques are available and used either alone or in combination with serum biomarkers. In the future, these noninvasive biomarkers will also be used as surrogate endpoints in therapy studies and to predict the benefit of drug therapies. The discussed biomarkers already allow identification of people requiring treatment and will play a crucial role in the personalized care of people with MASLD.