Non-invasive assessment of liver fibrosis among participants in a national screening program
- VernacularTitle:Эрт илрүүлэгт хамрагдагсдын дунд элэгний фиброзыг инвазив бус аргаар илрүүлсэн дүн
- Author:
Enkhjin B
1
;
Bira N
1
;
Sarantuya G
1
;
Sarantuya Ts
2
;
Oyunsuren E
3
;
Batzorig B
4
Author Information
1. Department of Gastroenterology, School of Medicine, MNUMS
2. Department of Gastroenterology, Intermed Hospital
3. Ministry of Health of Mongolia
4. Department of Epidemiology and Biostatistics, School of Public Health, MNUMS
- Publication Type:Journal Article
- Keywords:
Chronic liver disease;
Liver fibrosis;
Risk factors;
FIB-4 index
- From:
Mongolian Journal of Health Sciences
2026;95(5):270-274
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:Liver fibrosis is the underlying pathology of chronic liver disease complications, including cirrhosis and hepatocellular carcinoma, and its early detection is essential for preventing mortality and disease progression. Liver biopsy remains the gold standard for diagnosing fibrosis; however, it is invasive, costly, limited in repeatability, and not suitable for population-level screening. Moreover, liver fibrosis is often asymptomatic for a prolonged period, necessitating reliable and accessible methods for early identification of at-risk populations. Therefore, non-invasive approaches based on routine laboratory parameters, particularly the FIB-4 index, have been widely adopted in clinical practice.
Aim:To assess liver fibrosis using the FIB-4 index and to identify risk factors associated with indeterminate and high-risk groups among individuals participating in a national early detection program in Mongolia.
Materials and Methods:A total of 37,961 adults who met the inclusion and exclusion criteria were selected from 447,409 individuals who participated in the national early detection screening program between 2022 and 2023. The FIB-4 index was calculated using age, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count, and categorized as low (<1.3), indeterminate (1.3–2.67), and high (≥2.67) risk. Body mass index, blood pressure, fasting glucose, triglycerides, and viral hepatitis status were classified according to standard criteria. Statistical analyses were performed using SPSS version 21.0. Continuous variables were expressed as mean±standard deviation, categorical variables were compared using the χ² test, and logistic regression analysis was used to identify risk factors.
Results:The mean age of participants was 44.96±11.31 years, with 61.3% (n=23,285) female and 38.7% (n=14,676) male. The mean FIB-4 index was 0.89±1.09. Based on FIB-4, 86.9% were classified as low risk, 11.8% as indeterminate risk, and 1.4% as high risk; overall, 13.1% (n=4,975) were in the indeterminate and high-risk groups. FIB-4 risk increased progressively with age, reaching the highest level in individuals aged ≥60 years. In multivariable logistic regression analysis, male sex (OR=1.45; 95% CI: 1.36–1.56), viral hepatitis (OR=1.85; 95% CI: 1.68–2.03), and increasing age remained independently associated with indeterminate and high risk. Underweight status and very high triglyceride levels were associated with increased risk, whereas overweight, obesity, and central obesity showed an inverse association.
Conclusions:1. The FIB-4 index is a simple, cost-effective tool for identifying individuals at risk of liver fibrosis in primary healthcare settings. Male sex, older age, and viral hepatitis were independent risk factors for indeterminate and high-risk groups. 2. Therefore, the FIB-4 index can be implemented as an initial risk stratification tool in national screening programs to identify high-risk populations for further evaluation and management.
- Full text:2026100121354002088Эрт илрүүлэгт хамрагдагсдын дунд элэгний.pdf
