University of Massachusetts Chan Medical School - Baystate Health Springfield, MA
Safia Mohamed, MD1, Dimitri Melki, MD2, Sabah Sikander, DO3, Victoria Caruso, DO1, Mithil Gowda Suresh, MD4, Yesenia Greeff, MD5 1University of Massachusetts Chan Medical School - Baystate Health, Springfield, MA; 2University of Massachusetts Chan Medical School - Baystate Health, Windsor, CT; 3Baystate Medical Center, Springfield, MA; 4St. Vincent's Hospital, Chicopee, MA; 5University of Massachusetts Chan Medical School - Baystate Health, Northampton, MA Introduction: FIB-4 is widely used to assess fibrosis risk in patients with Type 2 Diabetes Mellitus (T2DM), but it relies on limited input variables and may misclassify risk. We aimed to develop and validate a novel MASLD Composite Risk Index (MCRI) that incorporates broader clinical and metabolic parameters to improve fibrosis risk stratification. Methods: We retrospectively analyzed 1,149 adult patients with T2DM seen in outpatient clinics. Elevated fibrosis risk was defined as FIB-4 >1.3. Eight variables (age, sex, race, BMI, A1c, AST, ALT, and platelets) were used to construct the MCRI using LASSO-penalized logistic regression. The model was trained to predict high FIB-4 as a surrogate for significant fibrosis. Performance was assessed using AUC, calibration plots, and comparison against the binary FIB-4 threshold. Results: MCRI retained six features after penalization (age, race, BMI, A1c, AST, and platelets). It achieved an AUC of 0.82, significantly outperforming the FIB-4 threshold alone (AUC = 0.51). Calibration analysis showed strong agreement between predicted and observed risk probabilities. The MCRI also maintained discriminatory power across sex and race subgroups, suggesting robust generalizability. Discussion: The MCRI is a promising risk stratification tool that improves upon FIB-4 by integrating metabolic and demographic information. Its superior performance and strong calibration suggest it may better identify T2DM patients at risk for advanced fibrosis, and support referral and imaging decisions in MASLD screening strategies.
Disclosures: Safia Mohamed indicated no relevant financial relationships. Dimitri Melki indicated no relevant financial relationships. Sabah Sikander indicated no relevant financial relationships. Victoria Caruso indicated no relevant financial relationships. Mithil Gowda Suresh indicated no relevant financial relationships. Yesenia Greeff indicated no relevant financial relationships.
Safia Mohamed, MD1, Dimitri Melki, MD2, Sabah Sikander, DO3, Victoria Caruso, DO1, Mithil Gowda Suresh, MD4, Yesenia Greeff, MD5. P1577 - Development and Validation of a Composite MASLD Risk Index (MCRI) in Patients With Type 2 Diabetes Mellitus: A Step Beyond FIB-4, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
