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Updated: May 29, 2026

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Histopathological Assessment Using SAF Scoring: Investigating Risk Factor Correlations with Disease Severity in MASLD

Xin Xin Li1, Ya Qin Zhang1, Shuo Jie Wang1

  • 1Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.

Biomedical and Environmental Sciences : BES
|May 28, 2026
PubMed
Summary

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This summary is machine-generated.

Body mass index (BMI), hyperuricemia, and non-invasive markers of hepatic steatosis (CAP) and fibrosis (LSM) are key predictors of significant liver lesions in metabolic dysfunction-associated steatotic liver disease (MASLD). These factors can improve risk stratification for advanced MASLD.

Area of Science:

  • Hepatology
  • Internal Medicine
  • Biomarkers

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing health concern.
  • Histologic assessment of MASLD activity and fibrosis is crucial for management but invasive.
  • Non-invasive methods are needed to identify patients with significant histologic lesions.

Purpose of the Study:

  • To identify risk factors for significant histologic lesions in MASLD using the SAF scoring system.
  • To develop a predictive model for significant histologic lesions in MASLD.

Main Methods:

  • Retrospective cohort study of 415 biopsy-proven MASLD patients.
  • Stratification into significant (SAF activity grade ≥ 3 and/or fibrosis stage ≥ 3) and non-significant lesion groups.
Keywords:
BMICAPLSMLiver fibrosisMASLDRisk predictionSAF scoreUric acid

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  • Analysis of demographic, laboratory, and imaging parameters, including CAP and LSM.

    • Main Results:

    • Significant lesions were associated with higher BMI, AST, ALT, UA, CAP, and LSM.
    • Multivariate analysis identified BMI, UA, CAP, and LSM as independent predictors.
    • The predictive model achieved an AUC of 75.18%.

    Conclusions:

    • BMI, hyperuricemia, hepatic steatosis (CAP), and fibrosis (LSM) are independent risk factors for advanced MASLD.
    • Non-invasive markers can effectively stratify MASLD patients.
    • Combined non-invasive assessment may enhance clinical risk stratification.