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Metabolic dysfunction–associated liver disease (MASLD) is an increasingly prevalent cause of cirrhosis and liver failure. However, MASLD and MASLD-associated advanced liver fibrosis likely are underdiagnosed, as clinicians face a bewildering array of calculators, proprietary blood tests, and imaging modalities without clear consensus on how and when to use these tools.
In a recent consensus report from the American Diabetes Association (ADA), writers aim to clarify recommendations for MASLD screening and risk stratification (Diabetes Care 2025 Jul; 48:1057). Fibrosis-4 index testing (FIB-4) should be done in patients with prediabetes or type 2 diabetes, especially those with obesity, and used as follows:
Patients with scores of <1.3, indicati…