Fibrosis index nine superiority for cirrhosis in hypopituitarism: Clinical validation of endocrine liver triage tool

Figure 4 Proposed fibrosis-9-guided screening algorithm for cirrhosis in patients with hypopituitarism. Patients with confirmed hypopituitarism should undergo calculation of the fibrosis-9 (FIB-9) score to assess liver fibrosis risk. If the FIB-9 score is ≥ 1.748, further evaluation is recommended, including liver stiffness measurement, hepatology consultation, and screening for complications. If the FIB-9 score is < 1.748, routine endocrine follow-up is advised, with consideration of repeat FIB-9 testing in 6-12 months if metabolic risk factors persist (e.g., obesity, diabetes mellitus, dyslipidemia). FIB-9: Fibrosis-9.