Introduction: The heterogeneous course of metabolic dysfunction-associated steatotic liver disease (MASLD)
across different populations necessitates the assessment of new indices and their validation at the local level.
Methods: We analyzed data from 43 patients who underwent transient elastography and had histologically
confirmed MASLD to validate the newly developed index for detecting compensated advanced chronic liver disease
– Compensated Advanced Steatotic Liver diseases Index (CASLI), as well as the Fibroscan-AST (FAST) and
Agile3+ scores.
The CASLI index was calculated using the following formula:
CASLI = 1 / (1 + e^-z) × 100%
z = -9,14 + 1,13×XT2DM + 1,77×XD + 0,05×XWC
where: XT2DM – presence of type 2 diabetes mellitus (0 – absent, 1 – present), XD – presence of dyslipidemia (0 –
absent, 1 – present), XWC – waist circumference (cm).
The discriminatory ability of the models was assessed using the area under the receiver operating characteristic
curve (AUROC). Statistical significance was set at p<0.05.
Results: The AUROC for CASLI was 0.87±0.06 (95% CI: 0.75–0.99, p = 0.004); for the FAST score (detecting
NASH + NAS≥4 + F≥2), 0.83±0.06 (95% CI: 0.7–0.95, p<0.0001); and for Agile3+ (detecting advanced fibrosis,
F≥3), 0.82±0.08 (95% CI: 0.67–0.98, p = 0.003). To improve diagnostic accuracy in the studied cohort, recalibrated
threshold values were determined: CASLI ≥0.2, FAST ≥0.52, Agile3+ ≥0.6.
Conclusions: The evaluated predictive models demonstrated their diagnostic effectiveness in identifying
progressive MASLD. CASLI showed the highest performance; however, threshold values require adjustment to
enhance diagnostic accuracy.