Parameter
| Biomarker | ELF Score | Full name | Enhanced Liver Fibrosis Score | Molecular Type | Multi-molecule combination score (containing hyaluronic acid, procollagen type III N-terminal peptide, tissue inhibitor of metalloproteinase-1) |
|---|---|---|---|---|---|
| Molecular Formula | Molecular Weight | Core Functional Dimensions | Assessment of LIVER fibrosis | ||
| Disease | Metabolic Associated Fatty Liver Disease (MASLD) | Disease Subtypes | / | ||
| Organ | Liver | Test Sample / Technology Platform | Serum | ||
| Pathobiological Mechanisms | It was calculated by the formula (FIB-4 = age ×AST/(platelet count ×√ALT)). Age reflects the cumulative effect of liver disease; AST/ALT ratio reflects the degree of liver cell injury. Platelet count is associated with portal hypertension and fibrosis (thrombocytopenia in fibrosis). FIB-4 can quickly assess the risk of fibrosis in patients with MASLD by simple clinical parameters Three serum markers (HA, PIIINP, TIMP-1) were calculated by the algorithm. HA reflects the function of hepatic sinusoidal endothelial cells and the degree of fibrosis. PIIINP reflects the rate of collagen synthesis, which is related to the early formation of liver fibrosis. TIMP-1 inhibits matrix metalloproteinase activity, inhibits collagen degradation, and promotes the progression of fibrosis. The ELF score can quantify the degree of liver fibrosis, and the higher the value, the more severe the fibrosis | ||||
| Clinical Availability Status | Non-invasive fibrosis screening markers are widely used in clinical practice and recommended by many guidelines for initial fibrosis stratification of MASLD, such as screening high-risk patients who need further liver biopsy or LSM testing Clinical biomarkers have been recommended by NICE and other guidelines for the screening of advanced fibrosis in MASLD patients and the evaluation of prognosis, such as the evaluation of the improvement effect of liraglutide on fibrosis | ||||
| Notes and Dynamics | FIB-4 is simple to calculate and has a high negative predictive value (>90%) for advanced fibrosis, which can effectively exclude low-risk patients. However, its accuracy decreases in middle-aged people (40-65 years old) and patients complicated with thrombocytopenia (such as other hematological diseases), so it needs to be interpreted with caution The ELF score combines the information of multiple fibrosis-related molecules and has a high diagnostic accuracy for advanced fibrosis (AUROC 0.80-0.90), which is convenient to detect and can reduce unnecessary liver biopsy. However, the accuracy is slightly lower in mild fibrosis stage, and it needs to be combined with LSM and other indicators | ||||