[Metabolic associated steatotic liver disease (MASLD) and hepatic fibrosis. Score proposal with FIB4+NFS+APRI]

.Introduction: liver fibrosis (FH) is one of the main risks and mortality factors for many patients. Metabolic syndrome, MASLD, alcoholism or hepatotropic viruses are the main causes of the development of FH. Due to the wide range of patients affected, FH screening is the order of the day. Furthermore, it is of enormous nutritional interest given that the only effective treatment today is diet and physical exercise. Metabolic syndrome and MASLD are closely linked. The prevalence of these is increasing and consequently, so is FH. Therefore, finding less invasive diagnostic strategies than liver biopsy (gold standard) is a priority. Objective: this study analyzes the relationship between age, sex, diabetes mellitus, hypertension, obesity and dyslipidemia with the development of FH. Material and methods: the diagnostic capacity of the main non-invasive markers available today is analyzed, as well as their confounding factors. Finally, a score with FIB4, NFS and APRI is proposed to improve their individual diagnostic capacity. Results: the prevalence of FH in the study is 44 %. Diabetes mellitus and hypertension are significant in the development of FH. For their part, FIB4, NFS and APRI show acceptable specificity, although in all of them platelets are an important confounding factor. Conclusions: the score of the three markers improves specificity (89.28 %), leaving fewer indeterminates than any of the indices. Therefore, it improves the diagnostic capacity compared to individual use.