Metabolic features’ effect on FibroScan-AST (FAST) score in Egyptian patients with metabolic dysfunction-associated steatotic liver disease (MASLD)

Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is rising these days together with type 2 diabetes (T2DM) and obesity levels, which is the leading cause of chronic liver disease globally. Noninvasive markers can be used to detect patients with severe fibrosis and active MASH. FibroScan-AST (FAST) score is a simplified combination score that accounts for controlled attenuation parameter (CAP), liver stiffness (LSM), and serum aspartate aminotransferase (AST). It has been utilized to recognize individuals with fibrotic metabolic associated steatohepatitis (MASH). This study's goal is to figure out the metabolic features linked to a high FAST score. Methods a cross-sectional study that involved 385 participants with MASLD collected from Fibroscan Unit, steatosis detected by VCTE-CAP elastography. Then, the FAST score was estimated sorting patients according to their risk of developing fibrotic MASH as low (< 0.35), medium (0.35–0.67), or high (> 0.67). Results Linear regression identified the cumulative number of metabolic criteria as a significant predictor of higher FAST score (B = 0.107, p < 0.001). In multivariable logistic regression, T2DM (OR = 3.62, 95% CI: 1.65–7.96, p = 0.001), hypertension (OR = 3.20, 95% CI: 1.45–7.07, p = 0.004), and dyslipidemia (OR = 3.28, 95% CI: 1.41–7.65, p = 0.006) were each independently associated with a high-risk FAST score. Age, sex, and body mass index were not significant predictors in the adjusted models. Conclusions calculating FAST score is crucial in identifying patients with fibrotic MASH. T2DM, Dyslipidemia, hypertension, and the presence of all cardiometabolic criteria have a substantially elevated risk of fibrosis and steatohepatitis. Trial registration NCT06867419