{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T22:57:34Z","timestamp":1770418654885,"version":"3.49.0"},"reference-count":12,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: New guidelines for management of metabolic-dysfunction-associated steatotic liver disease (MASLD) patients recommend an individualized medicine approach mainly targeting patients with fibrotic metabolic-dysfunction-associated steatohepatitis (MASH) and metabolic risk factors for progression of disease. This cohort study reports real-world experience for the individual evaluation and final diagnosis of patients on suspicion of fibrotic MASH according to standardized international criteria. We aimed to identify patients with significant fibrosis (F2\u2013F4). Methods: Adult patients with metabolic syndrome and\/or elevated alanine aminotransferases (ALT &gt; 50) referred in a 5-year period (2018\u20132022) on suspicion of fibrotic MASH were included. Medical history, anthropometric measurements, and routine (blood tests, ultrasound) and specific examinations were applied. Liver biopsy was offered for definite diagnosis and to evaluate MASLD characteristics. Patient demographics and characteristics as well as the absolute number and proportion of patients with definite MASLD and fibrotic MASH are reported. Results: A total of 137 adult patients were included. Ten percent of patients were evaluated without liver biopsy and diagnosed with chronic liver diseases other than MASLD. Liver-biopsied patients (n = 123) had a mean age (SD) of 49 (14) years, and 50% were males. Overweight or obesity was present in 94%, dyslipidemia in 74%, hypertension in 40%, and type 2 diabetes mellitus in 34%. Of all 137 patients, 104 (76%) were diagnosed with definite MASLD and 80 (58%) with definite MASH. A total of 74 (54%) patients had definite fibrotic MASH, while 41 (30%) had significant (F2\u20134) fibrotic MASH. Eight patients (6%) had cirrhotic (F4) MASH. A multivariate logistic regression analysis indicated that patients with type 2 diabetes, older age, and higher BMI were associated with an apparent increased risk of F2\u2013F4 fibrosis. Conclusions: The majority of referred patients had cardiometabolic\u2013hepatic metabolic risk factors and were diagnosed with definite MASLD. More than half of these were diagnosed with fibrotic MASH. Older age, type 2 diabetes, and higher BMI were apparent risk factors for MASH F2\u2013F4 fibrosis. We conclude that the individual cardiovascular\u2013hepatic risk profile applied supports the new guidelines and may be useful for referral and further evaluation at expert care centers in a real-world setting.<\/jats:p>","DOI":"10.3390\/jpm16020095","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T11:10:38Z","timestamp":1770376238000},"page":"95","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Individualized Evaluation on Suspicion of Fibrotic Metabolic-Dysfunction-Associated Steatohepatitis: Real-World Experience from a Referral Center in Denmark"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3304-212X","authenticated-orcid":false,"given":"Eva Efsen","family":"Dahl","sequence":"first","affiliation":[{"name":"Digestive Disease Center K, Bispebjerg University Hospital of Copenhagen, 2400 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9886-7299","authenticated-orcid":false,"given":"Gro Linno","family":"Willemoe","sequence":"additional","affiliation":[{"name":"Department of Pathology, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1305-3382","authenticated-orcid":false,"given":"Mark","family":"Berner-Hansen","sequence":"additional","affiliation":[{"name":"Digestive Disease Center K, Bispebjerg University Hospital of Copenhagen, 2400 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0344-9952","authenticated-orcid":false,"given":"Frank Vinholt","family":"Schi\u00f8dt","sequence":"additional","affiliation":[{"name":"Digestive Disease Center K, Bispebjerg University Hospital of Copenhagen, 2400 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"78","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100485","DOI":"10.1016\/j.jlr.2023.100485","article-title":"From NAFLD to MASLD: Updated naming and diagnosis criteria for fatty liver disease","volume":"65","author":"Rinella","year":"2024","journal-title":"J. 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(2021). Referral Patterns for Patients with Nonalcoholic Fatty Liver Disease. J. Clin. Med., 10.","DOI":"10.3390\/jcm10030404"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"106175","DOI":"10.1016\/j.cct.2020.106175","article-title":"The European NAFLD registry: A real-world longitudinal cohort study of nonalcoholic fatty liver disease","volume":"98","author":"Hardy","year":"2020","journal-title":"Contemp. Clin. Trials"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/2\/95\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T11:32:29Z","timestamp":1770377549000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/2\/95"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,6]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["jpm16020095"],"URL":"https:\/\/doi.org\/10.3390\/jpm16020095","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,6]]}}}