Evidence map›Paper›PMID 40754598›Full record

ArticleJournal of gastroenterology2025

Defining optimal fatty liver index thresholds for MASLD and MetALD using controlled attenuation parameter as reference.

Hideki Fujii, Sawako Uchida-Kobayashi, Atsushi Kanamori, Yuji Nadatani, Etsushi Kawamura, Tatsuo Kimura, Shinya Fukumoto, Toshio Watanabe

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Article in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hideki FujiiDepartment of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahimachi, Abeno, Osaka, 545-8585, Japan.ORCID 0000-0003-1267-9623
Sawako Uchida-KobayashiDepartment of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahimachi, Abeno, Osaka, 545-8585, Japan. sawako@omu.ac.jp.
Atsushi KanamoriPremier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-1-43, Abenosuji, Abeno, Osaka, 545-0052, Japan.
Yuji NadataniPremier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-1-43, Abenosuji, Abeno, Osaka, 545-0052, Japan.
Etsushi KawamuraPremier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-1-43, Abenosuji, Abeno, Osaka, 545-0052, Japan.
Tatsuo KimuraPremier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-1-43, Abenosuji, Abeno, Osaka, 545-0052, Japan.
Shinya FukumotoPremier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-1-43, Abenosuji, Abeno, Osaka, 545-0052, Japan.
Toshio WatanabePremier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-1-43, Abenosuji, Abeno, Osaka, 545-0052, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSimple, accurate methods are required for diagnosing metabolic dysfunction-associated steatotic liver disease (MASLD). Although the fatty liver index (FLI) is a simple and useful biomarker for steatotic liver disease (SLD), its optimal cutoff values for diagnosing MASLD and MASLD with increased alcohol intake (MetALD) remain unclear.

methodsThis cross-sectional study included 2512 adults undergoing health checkups with abdominal ultrasonography (AUS) and vibration-controlled transient elastography (including control attenuation parameter [CAP]). We used CAP 268 dB/m as the cutoff for SLD diagnosis. We analyzed the diagnostic performance of FLI for MASLD and MetALD. Optimal cutoff values were determined using area under receiver operating characteristics curve (AUROC) and Youden index.

resultsAmong 2512 individuals studied, 956 had SLD, including 648 with MASLD, 231 with MetALD, and 67 with alcohol-associated liver disease. The distribution of FLI values (< 30, 30-60, > 60) was 46%, 31%, and 23% in males and 83%, 12%, and 5%, in females. For MASLD, the AUROC and optimal FLI cutoff values were 0.786 and 26.7. When analyzing by sex, these values were 0.729 and 26.9 for males and 0.886 and 19.2 for females. For MetALD, the corresponding values were 0.835 and 34.5. When analyzing by sex, these values were 0.764 and 44.4 for males and 0.95and 30.8 for females. Diagnostic agreement rate between AUS and CAP was 78.3% in all, and 74.9% in males and 84.1% in females.

conclusionThe optimal FLI cutoff for MetALD was higher than for MASLD, with noticeable sex differences observed.

Indexed as

Alcohol DrinkingFatty LiverAdultAgedCross-Sectional StudiesElasticity Imaging TechniquesFemaleHumansMaleMiddle AgedROC CurveUltrasonographyAbdominal ultrasoundAlcohol intakeControl attenuation parameterFatty liver indexMetabolic dysfunction-associated steatotic liver disease

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.