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TL;DR
This narrative review evaluates noninvasive serum biomarkers like FIB-4 and NFS for identifying advanced liver fibrosis (≥F3) in NAFLD and their ability to predict clinical outcomes.
Clinical and Molecular Hepatology · 3 authors, 3 centres
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This narrative review evaluates noninvasive serum biomarkers like FIB-4 and NFS for identifying advanced liver fibrosis (≥F3) in NAFLD and their ability to predict clinical outcomes.
This narrative review synthesizes evidence on the performance and clinical utility of noninvasive serum biomarkers for liver fibrosis in non-alcoholic fatty liver disease (NAFLD). It summarizes findings from observational studies, systematic reviews, and meta-analyses showing that biomarkers like FIB-4, NFS, and ELF predict liver-related morbidity and mortality (e.g., ascites, hepatocellular carcinoma) and non-liver outcomes (e.g., cardiovascular mortality). The review highlights that while these biomarkers are effective for identifying advanced fibrosis (≥F3) and assessing prognosis, they have limited performance for diagnosing earlier F2 fibrosis or monitoring changes over time. A key limitation is the lack of evidence that a change in a biomarker score accurately reflects a change in liver fibrosis. The authors conclude that future biomarker development should focus on accurately identifying F2 fibrosis and validating use for monitoring therapeutic intervention response.