Risk score to predict fibrosis among Mexican adults: results of the Health Workers Cohort Study
Por:
Denova-Gutiérrez, E, Rivera-Paredez, B, Quezada-Sánchez, AD, Chávez-Tapia, N, Muñoz-Aguirre, P, Armenta-Guirado, B, Contreras, D, Flores, YN, Velázquez-Cruz, R, Salmerón, J
Publicada:
10 mar 2026
Resumen:
Background Fibrosis, a severe complication of metabolic-associated fatty liver disease, represents a major concern in the disease progression. Although liver biopsy remains the gold standard for fibrosis diagnosis, its invasive nature and high cost highlight the need for reliable non-invasive alternatives.Aim This study aimed to develop a simple, non-invasive fibrosis risk score based on clinical and biochemical variables in a Mexican population.Methods A total of 295 participants from the Health Workers Cohort Study were included. Fibrosis was assessed using transient elastography (FibroScan), which served as the reference standard for the development and validation of the risk score. Participants were classified according to the Meta-analysis of Histological Data in Viral Hepatitis (METAVIR) system. The diagnostic performance of candidate predictors was evaluated using receiver operating characteristic (ROC) curve analysis, and optimal cutoffs for fibrosis detection were identified.Results The fibrosis risk score developed for the Mexican population, including sex, triglycerides, glucose, waist circumference, hypertension, high-density lipoprotein cholesterol, body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and insulin, achieved an area under the ROC (AUROC) of 81.1% (95% CI, 74.4, 87.8). In the subsample with available insulin measurements, the AUROC was comparable (79.8, 95% CI, 72.9-86.8). When compared with existing fibrosis scores, including the BARD score (based on BMI, aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, and type 2 diabetes) and the AST/ALT ratio, the newly developed score demonstrated superior diagnostic accuracy for fibrosis detection.Conclusion This fibrosis risk score, based on routinely available clinical and biochemical data, demonstrated high diagnostic accuracy in the Mexican adult population. As a non-invasive tool, it may facilitate the early identification of fibrosis in primary care settings and reduce the need for liver biopsy. Further validation in larger and more diverse populations is warranted.
Filiaciones:
Inst Nacl Ciencias Med & Nutrit Salvador Zubiran, Dept Estudios Expt Rurales, Mexico City, Mexico
Univ Nacl Autonoma Mexico, Fac Med, Ctr Policy Populat & Hlth Res, Mexico City, Mexico
Natl Inst Publ Hlth, Ctr Evaluat & Surveys Res, Cuernavaca, Mexico
Med Clin & Foundation, Obes & Digest Dis Unit, Mexico City, Mexico
Natl Council Humanities Sci & Technol CONAHCYT, Mexico City, Mexico
Natl Inst Publ Hlth, Ctr Populat Hlth Res, Cuernavaca, Mexico
Univ Sonora, Dept Hlth Sci, Hermosillo, Mexico
Tecnol Monterrey, Sch Med & Hlth Sci, Santiago De Queretaro, Mexico
Mexican Social Secur Inst, Unit Epidemiol & Hlth Serv Res, Cuernavaca, Mexico
Fielding Sch Publ Hlth, UCLA Kaiser Permanente Ctr Hlth Equ, Ctr Canc Prevent & Control Res, UCLA Dept Hlth Policy & Man, Los Angeles, CA USA
Jonsson Comprehens Canc Ctr, Los Angeles, CA USA
Natl Inst Genom Med, Genom Bone Metab Lab, Mexico City, Mexico
Green Submitted, gold
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