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N\u2010terminal propeptide of collagen type 3 (PRO\u2010C3) is a biomarker of advanced fibrosis in MAFLD and PRO\u2010C3 may be involved in renal fibrosis. We aimed to use PRO\u2010C3 measurements to generate a new algorithmic score to test the prediction of MAFLD with chronic kidney disease (MAFLD\u2013CKD).<\/jats:p><\/jats:sec>Methods<\/jats:title>A derivation and independent validation cohort of 750 and 129 Asian patients with biopsy\u2010confirmed MAFLD were included. Serum PRO\u2010C3 concentration was measured and regression analyses were performed to examine associations with MAFLD\u2013CKD. A derivative algorithm for MAFLD\u2013CKD risk prediction was evaluated with receiver operator characteristic (ROC) curve analysis.<\/jats:p><\/jats:sec>Results<\/jats:title>The study included two Asian cohorts (n<\/jats:italic>\u2009=\u2009180 with MAFLD\u2013CKD; mean\u2010eGFR: 94.93\u2009mL\/min\/1.73 m2<\/jats:sup>; median\u2010urinary albumin\u2010to\u2010creatinine ratio: 6.58\u2009mg\/mmol). PRO\u2010C3 was associated with the severity of MAFLD\u2010CKD and independently associated with MAFLD\u2013CKD (adjusted odds ratio\u2009=\u20091.16, 95% confidence interval [CI]: 1.08\u20131.23, p<\/jats:italic>\u2009<\u2009.001). A new non\u2010invasive score (termed PERIOD) including PRO\u2010C3 efficiently predicted MAFLD\u2010CKD (AUROC\u2009=\u2009.842, 95% CI: .805\u2013.875). Accuracy, specificity and negative predictive values were 80.2%, 85.1% and 88.4%, respectively. In the validation cohort, the PERIOD score had good diagnostic performance (AUROC\u2009=\u2009.807, 95% CI: .691\u2013.893) with similar results in all patient subgroups. In the MAFLD\u2013CKD subgroup, the accuracy for identifying advanced fibrosis was further improved by combining the PRO\u2010C3\u2010based ADAPT with the Agile 3+ scores (AUROC\u2009=\u2009.90, 95% CI: .836\u2013.964).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The PERIOD score is helpful for accurately predicting the risk of MAFLD\u2013CKD. PRO\u2010C3 can also be used to assess liver fibrosis in people with MAFLD\u2013CKD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15878","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T12:04:45Z","timestamp":1709294685000},"page":"1129-1141","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Serum PRO\u2010C3 is useful for risk prediction and fibrosis assessment in MAFLD with chronic kidney disease in an Asian cohort"],"prefix":"10.1111","volume":"44","author":[{"given":"Liang\u2010Jie","family":"Tang","sequence":"first","affiliation":[{"name":"MAFLD Research Center, Department of Hepatology The First Affiliated Hospital of Wenzhou Medical University Wenzhou China"},{"name":"Cancer Center, Faculty of Health Sciences University of Macau Taipa Macau SAR 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