Exploration of Medicine

Table 6. Risk stratification models and prognostic predictors in MASLD.

Category	Model/factor	Description/cut-off	Prognostic implications	References
Three-tier models	FIB-4 < 1.3	Low risk, NPV approximately 90%	Outpatient follow-up	[80, 119]
	FIB-4 1.3–2.67	Intermediate risk	Requires second-level testing (elastography, ELF)	[80, 120]
	FIB-4 > 2.67	High risk	High probability of advanced fibrosis	[80, 119]
Clinical factors	Fibrosis ≥ F2	Associated with increased overall mortality	Indication for intensive surveillance	[117, 118]
	T2DM + MASLD	High-risk phenotype	Accelerated progression to cirrhosis and HCC	[57, 121]
	Older age, male sex, mixed dyslipidemia	Independent aggravating factors	Increased CV and renal risk	[48]
Integrative tools	SCORE2, ASCVD Risk Calculator	Cardiovascular risk integration	Greater predictive accuracy	[111]
Renal stratifiers	Albuminuria, reduced eGFR	Nephropathy risk assessment	CKD monitoring	[40, 41]
Emerging biomarkers	Pro-C3, “omics”, PNPLA3	Personalized approaches	Towards precision medicine	[41, 67, 115]

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CKD: chronic kidney disease; CV: cardiovascular; eGFR: estimated glomerular filtration rate; ELF: enhanced liver fibrosis; HCC: hepatocellular carcinoma; NPV: negative predictive value; T2DM: type 2 diabetes mellituss.

Declarations

Author contributions

CA: Writing—original draft, Supervision. RN, FB, KZ, LR, FCS, CC, and LEA: Writing—review & editing. AC: Supervision. All authors read and approved the final version.

Conflicts of interest

Ferdinando Carlo Sasso, who is the Editorial Board Member of Exploration of Medicine, had no involvement in the decision-making or the review process of this manuscript. The other authors declare no conflicts of interest.

Ethical approval

Not applicable. This article is a review of previously published literature and does not include original studies involving human participants or animals performed by any of the authors.

Consent to participate

Not applicable.

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Availability of data and materials

Not applicable. No datasets were generated or analyzed during the current study.

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