{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T04:08:23Z","timestamp":1793938103839,"version":"4.8.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004694","name":"Kaohsiung Medical University","doi-asserted-by":"publisher","award":["KMU\u2010TC114A08"],"award-info":[{"award-number":["KMU\u2010TC114A08"]}],"id":[{"id":"10.13039\/501100004694","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background\/Aims<\/jats:title>\n The association between metabolic dysfunction\u2010associated steatotic liver disease (MASLD), liver fibrosis, and coronary artery calcification (CAC) remains uncertain. We investigated their relationships and the predictive role of the Fibrosis\u20104 (FIB\u20104) index.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The study included 6058 subjects undergoing health check\u2010ups and coronary computed tomography. Steatotic liver disease (SLD) was identified via ultrasonography or hepatic steatosis index >\u200936. MASLD was defined as SLD with at least one of the five cardiometabolic risk factors. Liver fibrosis severity was assessed using the FIB\u20104 index to assess its association with CAC and predictive performance at different CAC thresholds.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n MASLD was present in 39.8% of participants, with a higher CAC prevalence than non\u2010MASLD individuals (51.1% vs. 42.5%,\n p<\/jats:italic>\n \u2009<\u20090.001). Factors associated with the presence of CAC included age (odds ratio [OR]\/95% confidence intervals [CI]: 1.117\/1.106\u20131.128,\n p<\/jats:italic>\n \u2009<\u20090.001), male gender (OR\/95% CI: 4.448\/3.660\u20135.406,\n p<\/jats:italic>\n \u2009<\u20090.001), MASLD (OR\/95% CI: 1.570\/1.342\u20131.837,\n p<\/jats:italic>\n \u2009<\u20090.001), and FIB\u20104 (OR\/95% CI: 1.217\/1.034\u20131.433,\n p<\/jats:italic>\n \u2009=\u20090.018). Among MASLD subjects, the prevalence of CAC increased with FIB\u20104 value and cardiometabolic burdens. FIB\u20104 values increased progressively in patients with higher coronary artery calcium scores (\n p<\/jats:italic>\n \u2010trend\u2009<\u20090.001). A FIB\u20104 cut\u2010off of \u2265\u20092.67 provided the highest positive predictive value (89.7%) for the presence of CAC, while a cut\u2010off of 1.26 offered the best negative predictive value (95.1%) for severe CAC.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n MASLD patients with elevated FIB\u20104 are at increased risk of coronary atherosclerosis. Incorporating FIB\u20104 into routine assessment may help identify high\u2010risk individuals who could benefit from early cardiology referral and preventive cardiovascular care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgh.70162","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T06:50:50Z","timestamp":1763794250000},"page":"332-340","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["FIB\u20104 Serves as a Referral Index for Coronary Artery Calcification in Patients With MASLD"],"prefix":"10.1111","volume":"41","author":[{"given":"Ya\u2010Chin","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine Kaohsiung Medical University Gangshan Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Department of Occupational & Environmental Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Doctoral Program of Clinical and Experimental Medicine, College of Medicine National Sun Yat\u2010sen University Kaohsiung Taiwan"},{"name":"Department of Preventive Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"School of Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease National Sun Yat\u2010sen University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4720-599X","authenticated-orcid":false,"given":"Chih\u2010Wen","family":"Wang","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Faculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of Medicine and Center of Metabolic Disorders and Obesity Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5897-2860","authenticated-orcid":false,"given":"Jiun\u2010Chi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Cheng","family":"Liang","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3728-7618","authenticated-orcid":false,"given":"Ming\u2010Lun","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"School of Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease National Sun Yat\u2010sen University Kaohsiung Taiwan"},{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Faculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of Medicine and Center of Metabolic Disorders and Obesity Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Kaohsiung Medical University Gangshan Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Department of Internal Medicine Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2961-130X","authenticated-orcid":false,"given":"Tyng\u2010Yuan","family":"Jang","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Faculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of Medicine and Center of Metabolic Disorders and Obesity Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Ju","family":"Wei","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Faculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of Medicine and Center of Metabolic Disorders and Obesity Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Yen","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Department of Internal Medicine Kaohsiung Medical University Gangshan Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao\u2010Kuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Department of Internal Medicine Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsu\u2010Han","family":"Chien","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Jen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of 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Hepatitis Research Center, School of Medicine, College of Medicine and Center of Metabolic Disorders and Obesity Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan\u2010Long","family":"Chuang","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Faculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of Medicine and Center of Metabolic Disorders and Obesity Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010I","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung 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Program in Translational Medicine, College of Medicine Kaohsiung Medical University, Kaohsiung, and Academia Sinica Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8145-1900","authenticated-orcid":false,"given":"Ming\u2010Lung","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease National Sun Yat\u2010sen University Kaohsiung Taiwan"},{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Faculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of Medicine and Center of Metabolic Disorders and Obesity Kaohsiung Medical University Kaohsiung 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