{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:42:54Z","timestamp":1789605774745,"version":"build-2803163510"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-18733-0","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T11:03:21Z","timestamp":1758884601000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Screening of advanced fibrosis and metabolic dysfunction-associated steatotic liver disease using transient elastography in vulnerable population"],"prefix":"10.1038","volume":"15","author":[{"given":"Robert","family":"Nastasa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Stanciu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ermina","family":"Stratina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Zenovia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remus","family":"Stafie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Rotaru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalin","family":"Sfarti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Girleanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horia","family":"Minea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana-Maria","family":"Singeap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Huiban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca","family":"Trifan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"issue":"10190","key":"18733_CR1","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1016\/S0140-6736(19)31429-1","volume":"393","author":"GBD 2017 Causes of Death Collaborators","year":"2019","unstructured":"GBD 2017 Causes of Death Collaborators. Global, regional, and National age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the global burden of disease study 2017 [published correction appears in. Lancet 393 (10190), e44 (2019).","journal-title":"Lancet"},{"issue":"1","key":"18733_CR2","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/j.1478-3231.2011.02517.x","volume":"32","author":"KM Fleming","year":"2012","unstructured":"Fleming, K. M., Aithal, G. P., Card, T. R. & West, J. All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study. Liver Int. 32 (1), 79\u201384 (2012).","journal-title":"Liver Int."},{"issue":"1","key":"18733_CR3","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1002\/hep.32163","volume":"75","author":"P Gin\u00e8s","year":"2022","unstructured":"Gin\u00e8s, P. et al. Population screening for liver fibrosis: toward early diagnosis and intervention for chronic liver diseases. Hepatology 75 (1), 219\u2013228 (2022).","journal-title":"Hepatology"},{"issue":"1","key":"18733_CR4","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1002\/hep.28431","volume":"64","author":"ZM Younossi","year":"2016","unstructured":"Younossi, Z. M. et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 64 (1), 73\u201384 (2016).","journal-title":"Hepatology"},{"issue":"4","key":"18733_CR5","first-page":"691","volume":"73","author":"G Targher","year":"2024","unstructured":"Targher, G., Byrne, C. D. & Tilg, H. MASLD: a systemic metabolic disorder with cardiovascular and malignant complications. Gut 73 (4), 691\u2013702 (2024). Published 2024 Mar 7.","journal-title":"Gut"},{"key":"18733_CR6","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1016\/j.jhep.2023.03.017","volume":"79","author":"H Devarbhavi","year":"2023","unstructured":"Devarbhavi, H. et al. Global burden of liver disease: 2023 update. J. Hepatol. 79, 516\u2013537 (2023).","journal-title":"J. Hepatol."},{"key":"18733_CR7","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","volume":"78","author":"ME Rinella","year":"2023","unstructured":"Rinella, M. E. et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatology 78, 1966\u20131986 (2023).","journal-title":"Hepatology"},{"key":"18733_CR8","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1111\/apt.17846","volume":"59","author":"R Loomba","year":"2024","unstructured":"Loomba, R. & Wong, V. W. S. Implications of the new nomenclature of steatotic liver disease and definition of metabolic dysfunction-associated steatotic liver disease. Aliment. Pharmacol. Ther. 59, 150\u2013156 (2024).","journal-title":"Aliment. Pharmacol. Ther."},{"issue":"3","key":"18733_CR9","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1016\/j.jhep.2018.05.011","volume":"69","author":"L Pimpin","year":"2018","unstructured":"Pimpin, L. et al. Burden of liver disease in europe: epidemiology and analysis of risk factors to identify prevention policies. J. Hepatol. 69 (3), 718\u2013735 (2018).","journal-title":"J. Hepatol."},{"issue":"3","key":"18733_CR10","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1097\/HEP.0000000000000604","volume":"79","author":"BP Lee","year":"2024","unstructured":"Lee, B. P., Dodge, J. L. & Terrault, N. A. National prevalence estimates for steatotic liver disease and subclassifications using consensus nomenclature. Hepatology 79 (3), 666\u2013673 (2024).","journal-title":"Hepatology"},{"issue":"1","key":"18733_CR11","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1053\/j.gastro.2019.09.008","volume":"158","author":"H Hagstr\u00f6m","year":"2020","unstructured":"Hagstr\u00f6m, H., Talb\u00e4ck, M., Andreasson, A., Walldius, G. & Hammar, N. Ability of noninvasive scoring systems to identify individuals in the population at risk for severe liver disease. Gastroenterology 158 (1), 200\u2013214 (2020).","journal-title":"Gastroenterology"},{"issue":"6","key":"18733_CR12","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1053\/j.gastro.2019.01.042","volume":"156","author":"PJ Eddowes","year":"2019","unstructured":"Eddowes, P. J. et al. Accuracy of fibroscan controlled Attenuation parameter and liver stiffness measurement in assessing steatosis and fibrosis in patients with nonalcoholic fatty liver disease. Gastroenterology 156 (6), 1717\u20131730 (2019).","journal-title":"Gastroenterology"},{"issue":"2","key":"18733_CR13","doi-asserted-by":"publisher","first-page":"e00c6","DOI":"10.1097\/HC9.0000000000000032","volume":"7","author":"A Trifan","year":"2023","unstructured":"Trifan, A. et al. High prevalence of liver fibrosis among general population: a Romanian population-based study [published correction appears in. Hepatol. Commun. 7 (2), e00c6 (2023).","journal-title":"Hepatol. Commun."},{"issue":"4","key":"18733_CR14","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/S1665-2681(19)31174-3","volume":"14","author":"N Ch\u00e1vez-Tapia","year":"2015","unstructured":"Ch\u00e1vez-Tapia, N. et al. Prevalence in vulnerable population of liver fibrosis identified by transient elastography. Ann. Hepatol. 14 (4), 524\u2013530 (2015).","journal-title":"Ann. Hepatol."},{"issue":"2","key":"18733_CR15","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1097\/ACO.0b013e32835e8c17","volume":"26","author":"DB Waisel","year":"2013","unstructured":"Waisel, D. B. Vulnerable populations in healthcare. Curr. Opin. Anaesthesiol. 26 (2), 186\u2013192 (2013).","journal-title":"Curr. Opin. Anaesthesiol."},{"issue":"20","key":"18733_CR16","first-page":"2725","volume":"11","author":"MC Wang","year":"2023","unstructured":"Wang, M. C., Bangaru, S. & Zhou, K. Care for vulnerable populations with chronic liver disease: A Safety-Net perspective. Healthc. (Basel). 11 (20), 2725 (2023).","journal-title":"Healthc. (Basel)"},{"issue":"4","key":"18733_CR17","doi-asserted-by":"publisher","first-page":"719","DOI":"10.5009\/gnl230220","volume":"18","author":"Y Zhu","year":"2024","unstructured":"Zhu, Y. et al. The association between educational attainment and the risk of nonalcoholic fatty liver disease among Chinese adults: findings from the REACTION study. Gut Liver. 18 (4), 719\u2013728 (2024).","journal-title":"Gut Liver"},{"key":"18733_CR18","unstructured":"WHO. Global Health Observatory (GHO) data repository. Body mass index (BMI). Accessed December 14, (2024)."},{"issue":"3","key":"18733_CR19","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1016\/j.jhep.2021.05.025","volume":"75","author":"European Association for the Study of the Liver; Clinical Practice Guideline Panel","year":"2021","unstructured":"European Association for the Study of the Liver; Clinical Practice Guideline Panel. Chair:; EASL governing board representative:; panel members:. EASL clinical practice guidelines on non-invasive tests for evaluation of liver disease severity and prognosis \u2013\u20092021 update. J. Hepatol. 75 (3), 659\u2013689 (2021).","journal-title":"J. Hepatol."},{"issue":"5","key":"18733_CR20","doi-asserted-by":"publisher","first-page":"997","DOI":"10.2214\/AJR.11.6677","volume":"199","author":"RH Marshall","year":"2012","unstructured":"Marshall, R. H., Eissa, M., Bluth, E. I., Gulotta, P. M. & Davis, N. K. Hepatorenal index as an accurate, simple, and effective tool in screening for steatosis. AJR Am. J. Roentgenol. 199 (5), 997\u20131002 (2012).","journal-title":"AJR Am. J. Roentgenol."},{"issue":"6","key":"18733_CR21","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1016\/j.ypmed.2012.10.002","volume":"55","author":"LN Borrell","year":"2012","unstructured":"Borrell, L. N. & Joseph, S. P. Health disparities: the role of preventive medicine in closing the gap. Prev. Med. 55 (6), 569\u2013570 (2012).","journal-title":"Prev. Med."},{"issue":"5","key":"18733_CR22","doi-asserted-by":"publisher","first-page":"e0413","DOI":"10.1097\/HC9.0000000000000413","volume":"8","author":"M Brahmania","year":"2024","unstructured":"Brahmania, M. et al. Pragmatic strategies to address health disparities along the continuum of care in chronic liver disease. Hepatol. Commun. 8 (5), e0413 (2024).","journal-title":"Hepatol. Commun."},{"key":"18733_CR23","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","volume":"396","author":"T Vos","year":"2020","unstructured":"Vos, T. et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the global burden of disease study 2019. Lancet 396, 1204\u20131222 (2020).","journal-title":"Lancet"},{"issue":"3","key":"18733_CR24","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/j.aohep.2020.01.003","volume":"19","author":"D Garc\u00eda-Compe\u00e1n","year":"2020","unstructured":"Garc\u00eda-Compe\u00e1n, D. et al. Prevalence of liver fibrosis in an unselected general population with high prevalence of obesity and diabetes mellitus. Time for screening? Ann. Hepatol. 19 (3), 258\u2013264 (2020).","journal-title":"Ann. Hepatol."},{"issue":"6","key":"18733_CR25","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1016\/j.jhep.2019.08.019","volume":"71","author":"M Serra-Burriel","year":"2019","unstructured":"Serra-Burriel, M. et al. Transient elastography for screening of liver fibrosis: Cost-effectiveness analysis from six prospective cohorts in Europe and Asia. J. Hepatol. 71 (6), 1141\u20131151 (2019).","journal-title":"J. Hepatol."},{"issue":"5","key":"18733_CR26","doi-asserted-by":"publisher","first-page":"e0251741","DOI":"10.1371\/journal.pone.0251741","volume":"16","author":"SE Congly","year":"2021","unstructured":"Congly, S. E., Shaheen, A. A. & Swain, M. G. Modelling the cost effectiveness of non-alcoholic fatty liver disease risk stratification strategies in the community setting. PLoS One. 16 (5), e0251741 (2021).","journal-title":"PLoS One"},{"issue":"10","key":"18733_CR27","doi-asserted-by":"publisher","first-page":"2449","DOI":"10.2337\/dc22-0556","volume":"45","author":"RG Kim","year":"2022","unstructured":"Kim, R. G., Deng, J., Reaso, J. N., Grenert, J. P. & Khalili, M. Noninvasive fibrosis screening in fatty liver disease among vulnerable populations: impact of diabetes and obesity on FIB-4 score accuracy. Diabetes Care. 45 (10), 2449\u20132451 (2022).","journal-title":"Diabetes Care"},{"issue":"12","key":"18733_CR28","doi-asserted-by":"publisher","first-page":"2045","DOI":"10.1136\/gutjnl-2024-332917","volume":"73","author":"AH Yang","year":"2024","unstructured":"Yang, A. H. et al. Prevalence of steatotic liver disease, advanced fibrosis and cirrhosis among community-dwelling overweight and obese individuals in the USA. Gut 73 (12), 2045\u20132053 (2024).","journal-title":"Gut"},{"issue":"6","key":"18733_CR29","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1016\/j.cgh.2023.11.003","volume":"22","author":"M Kalligeros","year":"2024","unstructured":"Kalligeros, M. et al. Prevalence of steatotic liver disease (MASLD, metald, and ALD) in the united states: NHANES 2017\u20132020. Clin. Gastroenterol. Hepatol. 22 (6), 1330\u20131332e4 (2024).","journal-title":"Clin. Gastroenterol. Hepatol."},{"issue":"11","key":"18733_CR30","doi-asserted-by":"publisher","first-page":"2425","DOI":"10.1111\/liv.15695","volume":"43","author":"S Ciardullo","year":"2023","unstructured":"Ciardullo, S., Carbone, M., Invernizzi, P. & Perseghin, G. Exploring the landscape of steatotic liver disease in the general US population. Liver Int. 43 (11), 2425\u20132433 (2023).","journal-title":"Liver Int."},{"issue":"3","key":"18733_CR31","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1111\/liv.15122","volume":"42","author":"A Hashim","year":"2022","unstructured":"Hashim, A. et al. Chronic liver disease in homeless individuals and performance of non-invasive liver fibrosis and injury markers: VALID study. Liver Int. 42 (3), 628\u2013639 (2022).","journal-title":"Liver Int."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-18733-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-18733-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-18733-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T11:03:23Z","timestamp":1758884603000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-18733-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,26]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["18733"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-18733-0","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,26]]},"assertion":[{"value":"24 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was approved by the ethics committee of Institute of Gastroenterology and Hepatology Iasi and the University of Medicine and Pharmacy \u201cGr. T. Popa\u201d, Iasi, ratified this with approval number 174.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statement"}}],"article-number":"33028"}}