Abstracts of the 2025 Annual Meeting of the ALEH
More infoMASLD is highly prevalent worldwide. We evaluated performance of NITs and predictors of outcomes in patients with MASLD from Latin America (LA) as compared to North America (NA).
Patients and MethodsThe Global-MASLD project enrolled MASLD patients with liver biopsies and NITs (FIB-4, liver stiffness measurement (LSM) by transient elastography). NITs’ performance to predict advanced fibrosis (AF=F3-F4) and outcomes was assessed.
ResultsA total of 3,904 MASLD patients were included [N=892 from 5 LA countries (Argentina, Brazil, Chile, Cuba, Mexico) and N=3012 from NA (USA/Canada). MASLD patients from LA were older, had lower BMI (obesity 64% vs. 85%), more lean MASLD (5.6% vs. 2.7%), more T2D (49% vs. 38%) (p<0.001) but similar rates of AF (p=0.56). Clinico-demographic predictors of AF included older age and T2D (p<0.05). The NIT accuracy was lower in LA-MASLD than NA-MASLD: AUC (95% CI) of FIB-4 0.75 (0.71-0.79) vs. 0.81 (0.79-0.83), LSM 0.73 (0.67-0.80) vs. 0.78 (0.75-0.81), Agile-3+ 0.76 (0.70-0.82) for both LA and NA. Sensitivity of 80% (low-risk, screening cutoff) was achieved with FIB-4 ≥1.01 in LA vs. FIB-4 ≥1.17 in NA; specificity of 95% (high-risk, diagnostic cutoff) with FIB-4 ≥2.35 vs. FIB-4 ≥2.40. In adjusted (age, sex, T2D) proportional hazards models, fibrosis severity by histology or NITs was associated with adverse outcomes (death, decompensation, HCC) in both groups (adjusted hazard ratios (aHR) >1.0) (Figure).
ConclusionsMASLD patients from LA have more T2D but less obesity than NA. Common NITs have lower accuracy in LA-MASLD. Histologic and NIT stage of fibrosis are independent predictors of adverse outcomes in both groups.
