{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:14:43Z","timestamp":1780578883244,"version":"3.54.1"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Turkish Journal of Gastroenterology"],"abstract":"<jats:p>Background\/Aims: Metabolic dysfunction\u2013associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease, with significant fibrosis (\u2265F2) strongly associated with adverse outcomes. The current study evaluated the diagnostic value of serum fibroblast growth factor 21 (FGF-21) combined with the fibrosis-4 index (FIB-4) for the assessment of hepatic fibrosis in patients with MASLD.\r\nMaterials and Methods: A total of 125 patients with MASLD were enrolled (91 patients with F0-F1 fibrosis and 34 patients with F2-F4 fibrosis). Independent risk factors for significant fibrosis were identified using multivariate logistic regression. A combined diagnostic model was developed and validated using bootstrap resampling (500 iterations). Diagnostic performance was evaluated using receiver operating characteristic curve analysis.\r\nResults: Compared to the F0-F1 fibrosis group, patients with F2-F4 fibrosis had significantly higher waist circumference (WC), gammaglutamyl transferase (GGT), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol, FIB-4 index, and FGF-21 levels and significantly lower high-density lipoprotein cholesterol (HDL-C) levels. Multivariate analysis identified FIB-4, FGF-21, WC, GGT, and HOMA-IR as independent risk factors, whereas HDL-C was identified as a protective factor. The combined model achieved an area under the curve of 0.806 (95% CI: 0.727-0.886), outperforming FIB-4 (0.743) and FGF-21 (0.735) alone. At the optimal cutoff determined by the Youden index, the combined model maintained comparable specificity while significantly improving sensitivity to 94.12%. The model also demonstrated balanced performance under both specificity-driven and sensitivitydriven strategies.\r\nConclusion: Combining FGF-21 with FIB-4 improved diagnostic accuracy for significant fibrosis in MASLD, providing a practical, noninvasive tool for early risk assessment and patient stratification.\r\nCite this article as: Cao Y, Zhang X, Zhang Q. Diagnostic value of serum fibroblast growth factor 21 combined with fibrosis-4 index for hepatic fibrosis in metabolic dysfunction\u2013associated steatotic liver disease. Turk J Gastroenterol. Published online June 2, 2026. doi: 10.5152\/tjg.2026.25740.<\/jats:p>","DOI":"10.5152\/tjg.2026.25740","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:58:43Z","timestamp":1780577923000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Value of Serum Fibroblast Growth Factor 21 Combined with Fibrosis-4 Index for Hepatic Fibrosis in Metabolic Dysfunction\u2013Associated Steatotic Liver Disease"],"prefix":"10.5152","author":[{"given":"Yang","family":"Cao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3111","published-online":{"date-parts":[[2026,6,2]]},"container-title":["Turkish Journal of Gastroenterology"],"original-title":[],"link":[{"URL":"https:\/\/www.turkjgastroenterol.org\/index.php\/tjg\/article\/download\/4696\/4399","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.turkjgastroenterol.org\/index.php\/tjg\/article\/download\/4696\/4399","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:58:43Z","timestamp":1780577923000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.turkjgastroenterol.org\/index.php\/tjg\/article\/view\/4696"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,2]]},"references-count":0,"URL":"https:\/\/doi.org\/10.5152\/tjg.2026.25740","relation":{},"ISSN":["2148-5607"],"issn-type":[{"value":"2148-5607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,2]]}}}