Hu HS, Xu LS, Sun BQ. Letter to the Editor: Enhancing fibrosis prediction in metabolic dysfunction-associated steatotic liver disease: The potential of combined biomarker approaches. World J Hepatol 2026; 18(9): 119430 [DOI: 10.4254/wjh.119430]
Corresponding Author of This Article
Bao-Qing Sun, Professor, Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, No. 28 Qiaozhong Middle Road, Guangzhou 510120, Guangdong Province, China. sunbaoqing@vip.163.com
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Medicine, Research & Experimental
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letter
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Hu HS, Xu LS, Sun BQ. Letter to the Editor: Enhancing fibrosis prediction in metabolic dysfunction-associated steatotic liver disease: The potential of combined biomarker approaches. World J Hepatol 2026; 18(9): 119430 [DOI: 10.4254/wjh.119430]
World J Hepatol. Sep 27, 2026; 18(9): 119430 Published online Sep 27, 2026. doi: 10.4254/wjh.119430
Letter to the Editor: Enhancing fibrosis prediction in metabolic dysfunction-associated steatotic liver disease: The potential of combined biomarker approaches
Hai-Sheng Hu, Lin-Shu Xu, Bao-Qing Sun
Hai-Sheng Hu, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China
Lin-Shu Xu, The First Clinical College, Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China
Bao-Qing Sun, Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China
Co-first authors: Hai-Sheng Hu and Lin-Shu Xu.
Author contributions: Hu HS and Xu LS contributed to the writing and editing of the manuscript and illustrations; Sun BQ designed the overall concept and outline of the manuscript; all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Bao-Qing Sun, Professor, Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, No. 28 Qiaozhong Middle Road, Guangzhou 510120, Guangdong Province, China. sunbaoqing@vip.163.com
Received: January 28, 2026 Revised: February 4, 2026 Accepted: March 3, 2026 Published online: September 27, 2026 Processing time: 233 Days and 2.8 Hours
Core Tip
Core Tip: This letter highlights the limited diagnostic accuracy of conventional markers (e.g., neutrophil-to-lymphocyte ratio and C-reactive protein) for predicting liver fibrosis in metabolic dysfunction-associated steatotic liver disease. To advance precision management, we propose a shift toward an integrated diagnostic paradigm. This strategy combines accessible systemic inflammation indices with novel biomarkers reflecting specific hepatic processes, such as N-terminal propeptide of type III collagen for fibrogenesis, liver-specific microRNAs, and metabolic proteins, such as fatty acid-binding protein 4. Future research should prioritize validating such mechanism-informed combinations to enable multidimensional risk assessment, establish actionable clinical thresholds, and guide personalized monitoring and intervention, ultimately improving prognosis in this heterogeneous patient population.
