Associations of Metabolomic and Clinical Risk Scores with MRI Biomarkers for Liver Disease
Year: 2026
Type: article
Abstract: Chronic liver disease is a life-altering condition that often progresses asymptomatically until advanced stages. Promisingly, earlier stages of liver disease have been seen to be reversible. However, the current screening recommendations are unstandardized, and the clinical scores typically used are part of a multi-step process, ending in an invasive liver biopsy for proper diagnosis. These clinical scores may also yield false positives or provide limited information beyond anthropometric measurements. Thus, there is a growing interest in developing reliable, non-invasive diagnostic tools and risk prediction models to help prevent end-stage liver disease. Using data from the UK Biobank and Nightingale Health, this study investigated the associations between previously validated metabolomic risk scores (MRS) for liver cirrhosis, the clinical fatty liver index (FLI), and two magnetic resonance imaging (MRI) biomarkers, proton density fat fraction (PDFF) and corrected T1 (cT1), across two incident liver outcomes. These outcomes, fatty liver and major liver events, reflect stage one and stage four liver diseases, respectively. To begin, the individual associations of the MRS and FLI score across three abnormal MRI groups were first investigated using logistic generalized linear models. Then, multiple Cox proportional hazards models were performed to evaluate associations between each risk score and continuous cT1 for both liver outcomes. Finally, Fisher’s exact tests were utilized to investigate the enrichment of cases within the top decile of each risk score in both the full population and among individuals with elevated PDFF (≥ 5%). It was found that the FLI score (interaction model HR: 2.60, 95% CI: 1.73-3.90) and cT1 (interaction model HR: 1.67, 95% CI: 1.22-2.27) were consistently associated with fatty liver events across Cox analyses. For major liver events, both MRS and cT1 showed significant elevated hazards with evidence of a joint interaction between the MRS and cT1 (interaction HR: 1.34, 95% CI: 1.11-1.62). Fisher’s exact tests also demonstrated significant enrichment of cases within the top decile of both risk scores across both liver outcomes. The strongest enrichment was observed for major liver events among individuals with elevated PDFF in the top MRS decile (OR: 10.15, 95% CI: 3.05-38.61). These results highlight the potential of MRS alongside MRI biomarkers as a non-invasive tool for risk stratification, particularly for major liver events. Moreover, these results illuminate the importance of the continued investigation of MRS with clinical and imaging measurements to improve population-level screening strategies for chronic liver disease.
Source: Työväentutkimus Vuosikirja
Author: Gruszczynski, Audrey
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7198392605