Nonalcoholic fatty liver disease (NAFLD) affects approximately 30% of the population worldwide and includes nonalcoholic fatty liver, nonalcoholic steatohepatitis (NASH), and cirrhosis. Since NAFLD-associated diseases begin with steatosis, the early diagnosis of steatosis helps to prevent the progression of NASH and fibrosis. In addition, more convenient and easily diagnosable serum biomarkers are becoming crucial in disease diagnosis. In this report, we summarize the known serum biomarkers for liver steatosis and provide guidance for their application in clinical practice.
Citations
Citations to this article as recorded by
Evolution of Multivalent Aptamer Corona for High‐Throughput Multiplexed Detection of Multiple Cancers Mengjie Wang, Baichuan Jin, Xin Dai, Haozhe Huang, Qiqi Liu, Jianqing Zhu, Haixing Ju, Qixun Chen, Yongmei Song, Weihong Tan, Yuan Liu Advanced Science.2026;[Epub] CrossRef
Identification of Circulating MiR-4651 as Novel Biomarker for Metabolic Dysfunction–associated Steatotic Liver Disease Mélanie Kirchmeyer, Anthoula Gaigneaux, Florence A. Servais, Anita Arslanow, Claudia Rubie, Markus Casper, Matthias Glanemann, María L. Martínez-Chantar, Marcin Krawczyk, Frank Lammert, Iris Behrmann Gastro Hep Advances.2026; 5(2): 100839. CrossRef
FIB‐4 Serves as a Referral Index for Coronary Artery Calcification in Patients With MASLD Ya‐Chin Huang, Chih‐Wen Wang, Jiun‐Chi Huang, Po‐Cheng Liang, Ming‐Lun Yeh, Yi‐Yu Chen, Yi‐Hung Lin, Tyng‐Yuan Jang, Yu‐Ju Wei, Ming‐Yen Hsieh, Chao‐Kuan Huang, Hsu‐Han Chien, Chia‐Jen Wu, Jee‐Fu Huang, Chia‐Yen Dai, Wan‐Long Chuang, Chia‐I Lin, Chung‐Fen Journal of Gastroenterology and Hepatology.2026; 41(1): 332. CrossRef
I-FABP, citrulline and non-invasive liver dysfunction indices in patients with depression – cross-sectional study results Jakub Rogalski, Joanna Grzelczyk, Aleksandra Margulska, Grzegorz Mirocha, Grażyna Budryn, Dominik Strzelecki, Oliwia Gawlik-Kotelnicka BMC Gastroenterology.2026;[Epub] CrossRef
New Treatment Options for MASLD Patients with Type 2 Diabetes Andrea Mega, Chiara Turri, Luca Marzi, Marco Dauriz, Rodolfo Sacco, Annarosa Floreani, Cristina Stasi Life.2026; 16(2): 254. CrossRef
Performance of three clinical scores for steatosis and steatohepatitis and their interaction with metabolic syndrome in obese individuals Giovani Schulte Farina, Bárbara Brambilla, Emanuelle Mendonça Pandolfo, Laura Kalil Nader Lazzaretti, Stéfano Mateus Schio Kuiava, Ana Maria Graciolli, Vitória Maria Kriger, Carlos Henrique Dal Bem Fistarol, Augusto Cardoso Sgarioni, Henrique Prataviera G World Journal of Hepatology.2026;[Epub] CrossRef
Performance of Noninvasive Indices for Discrimination of Metabolic Dysfunction-Associated Steatotic Liver Disease in Young Adults Jaejun Lee, Chang In Han, Dong Yeup Lee, Pil Soo Sung, Si Hyun Bae, Hyun Yang Gut and Liver.2025; 19(1): 116. CrossRef
Noninvasive identification of metabolic dysfunction–associated steatohepatitis (INFORM MASH): a retrospective cohort and disease modeling study G. Craig Wood, Anthony Hoovler, Rakesh Luthra, Christopher D. Still, Hamzah Shariff, Matthew Still, Jonathan Hayes, Peter Benotti, Chioma Uzoigwe Expert Review of Gastroenterology & Hepatology.2025; 19(4): 427. CrossRef
Updated recommendations for the management of metabolic dysfunction–associated steatotic liver disease (MASLD) by the Latin American working group Luis Antonio Diaz, Juan Pablo Arab, Francisco Idalsoaga, Javiera Perelli, Javier Vega, Melisa Dirchwolf, Javiera Carreño, Bárbara Samith, Cynthia Valério, Rodrigo Oliveira Moreira, Mónica Acevedo, Javier Brahm, Nelia Hernández, Adrian Gadano, Claudia P. O Annals of Hepatology.2025; 30(2): 101903. CrossRef
Atherogenic index of plasma identifies subjects with severe liver steatosis Carlo De Matteis, Fabio Novielli, Ersilia Di Buduo, Maria Arconzo, Raffaella Maria Gadaleta, Marica Cariello, Antonio Moschetta, Lucilla Crudele Scientific Reports.2025;[Epub] CrossRef
Construction and evaluation of a diagnostic model for metabolic dysfunction-associated steatotic liver disease based on advanced glycation end products and their receptors Xiao Cao, Xiaohua Xiao, Peipei Jiang, Nian Fu Frontiers in Medicine.2025;[Epub] CrossRef
Analysis the Mechanism of HerbaArtemisiaescopariae and Folium nelumbinis in the Treatment of Non-Alcoholic Fatty Liver Disease Based on Network Pharmacology 鑫凤 娄 Traditional Chinese Medicine.2025; 14(04): 1253. CrossRef
Management of metabolic dysfunction–associated steatotic liver disease (MASLD)—An expert consensus statement from Indian diabetologists' perspective Abdul Hamid Zargar, Anil Bhansali, Anirban Majumdar, Anuj Maheshwari, Arpandev Bhattacharyya, Arundhati Dasgupta, Banshi Damodarlal Saboo, Bipin Kumar Sethi, Debmalya Sanyal, Krishna G. Seshadri, Neeta Rohit Deshpande, Nitin Kapoor, Om Jitendra Lakhani, P Diabetes, Obesity and Metabolism.2025; 27(S4): 3. CrossRef
The value of ultrasonic attenuation parameters and serum indicators on MASLD patients with liver fat degenerationality Yan Liu, Wen Kang, Jingya Su, Yin Yang, Kui Li, Juntao Yang Journal of Radiation Research and Applied Sciences.2025; 18(3): 101647. CrossRef
Associations Between Shift Work, Sociodemographic and Lifestyle Characteristics, Body Measurements, and MASLD Javier Tosoratto, Pedro Juan Tárraga López, Ángel Arturo López-González, Carla Busquets-Cortes, Joan Obrador de Hevia, José Ignacio Ramirez-Manent Life.2025; 15(6): 961. CrossRef
L-Phenylalanine promotes liver steatosis by inhibiting BNIP3-mediated mitophagy Ying Sun, Lingli Cai, Bowei Yu, Haojie Zhang, Ziteng Zhang, Xiaoqin Xu, Yuefeng Yu, Jiang Li, Chi Chen, Fangzhen Xia, Yingli Lu, Kun Zhang, Ningjian Wang Molecular Medicine.2025;[Epub] CrossRef
MOFI-FL, a novel score for detecting hepatic steatosis and predicting cardiometabolic mortality Juan Reyes-Barrera, Rosalinda Posadas-Sánchez, Gilberto Vargas-Alarcón, Guillermo C. Cardoso-Saldaña, Paloma Almeda-Valdes, Omar Yaxmehen Bello Chavolla, Luis Ortiz-Hernandez, Neftali Eduardo Antonio-Villa Scientific Reports.2025;[Epub] CrossRef
Quantification of liver steatosis of metabolic dysfunction-associated steatotic liver disease based on body composition analysis Toshikazu Kohira, Satoshi Oeda, Erina Eto, Yoshihito Kubotsu, Misa Norita, Kaori Inoue, Nagisa Hara, Shotaro Noge, Kenichi Tanaka, Shigenobu Yoshimura, Noriko Oza, Keizo Anzai, Yuichiro Eguchi, Cheng Han Ng, Daniel Q. Huang, Mark D. Muthiah, Atsushi Kawag Scientific Reports.2025;[Epub] CrossRef
Metabolic and hepatic biomarkers associated with MASLD in the Chinese population Hua Chen, Zexu Chen, Xinyan Bai, Zhaohua Li, Songqi Huang, Dawei Lu, Jue Li, Yunfei Wang, Lu Han, Kun Xia, Shuqiong Huang Scientific Reports.2025;[Epub] CrossRef
Discovery of ultrasound-derived fat fraction as a non-invasive tool for MASLD diagnosis Huiru Jin, Mengfan Jiao, Chengxiao Yu, Tingting Ren, Qingling Chen, Zixing Dai, Erfu Xie, Longfeng Jiang, Yuwen Li European Journal of Medical Research.2025;[Epub] CrossRef
Metabolic Dysfunction‐Associated Steatotic Liver Disease (MASLD): Mechanisms, Clinical Implications and Therapeutic Advances Dalia M. Miller, Kiana F. McCauley, Kimberly J. Dunham‐Snary Endocrinology, Diabetes & Metabolism.2025;[Epub] CrossRef
From fatty liver indices to the Zhejiang University index: Re-shaping risk stratification of metabolic liver disease in diabetes Mostafa M Gouda World Journal of Diabetes.2025;[Epub] CrossRef
The interplay of metabolic dysfunction‐associated fatty liver disease and viral hepatitis on liver disease severity: A large community‐based study in a viral endemic area Chung‐Feng Huang, Po‐Cheng Liang, Pei‐Chien Tsai, Yu‐Ju Wei, Ching‐I Huang, Chih‐Wen Wang, Tyng‐Yuan Jang, Ming‐Lun Yeh, Po‐Yao Hsu, Ming‐Yen Hsieh, Yi‐Hung Lin, Chia‐Yen Dai, Wan‐Long Chuang, Jee‐Fu Huang, Ming‐Lung Yu Journal of Gastroenterology and Hepatology.2024; 39(1): 193. CrossRef
Metabolic-associated fatty liver disease: a selective review of pathogenesis, diagnostic approaches, and therapeutic strategies Mohammad Habibullah, Khaleed Jemmieh, Amr Ouda, Mohammad Zulqurnain Haider, Mohammed Imad Malki, Abdel-Naser Elzouki Frontiers in Medicine.2024;[Epub] CrossRef
Prevalence of at‐risk MASH, MetALD and alcohol‐associated steatotic liver disease in the general population Carolin V. Schneider, Kai Markus Schneider, Anastasia Raptis, Helen Huang, Christian Trautwein, Rohit Loomba Alimentary Pharmacology & Therapeutics.2024; 59(10): 1271. CrossRef
Type 2 diabetes mellitus and cardiometabolic outcomes in metabolic dysfunction-associated steatotic liver disease population Nicholas W.S. Chew, Xin Hui Pan, Bryan Chong, Chanchal Chandramouli, Mark Muthiah, Carolyn S.P. Lam Diabetes Research and Clinical Practice.2024; 211: 111652. CrossRef
High-Sensitivity C-Reactive Protein Levels in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), Metabolic Alcohol-Associated Liver Disease (MetALD), and Alcoholic Liver Disease (ALD) with Metabolic Dysfunction Seong-Uk Baek, Jin-Ha Yoon Biomolecules.2024; 14(11): 1468. CrossRef
Fatty Acids and Bilirubin as Intrinsic Autofluorescence Serum Biomarkers of Drug Action in a Rat Model of Liver Ischemia and Reperfusion Anna C. Croce, Andrea Ferrigno, Giuseppina Palladini, Barbara Mannucci, Mariapia Vairetti, Laura G. Di Pasqua Molecules.2023; 28(9): 3818. CrossRef
The Role of the Fatty Liver Index (FLI) in the Management of Non-Alcoholic Fatty Liver Disease: A Systematic Review Teodora Biciusca, Sorina Ionelia Stan, Mara Amalia Balteanu, Ramona Cioboata, Alice Elena Ghenea, Suzana Danoiu, Ana-Maria Bumbea, Viorel Biciusca Diagnostics.2023; 13(21): 3316. CrossRef
Quantitative ultrasound envelope statistics imaging as a screening approach for pediatric hepatic steatosis and liver fibrosis: using biomarker and transient elastography as reference standards Chiao-Shan Hsieh, Ming-Wei Lai, Chien-Chang Chen, Hsun-Chin Chao, Chiao-Yin Wang, Yung-Liang Wan, Zhuhuang Zhou, Po-Hsiang Tsui Heliyon.2023; 9(12): e22743. CrossRef
Alcohol consumption and the risk of liver disease: a nationwide, population-based study Sang Yi Moon, Minkook Son, Yeo Wool Kang, Myeongseok Koh, Jong Yoon Lee, Yang Hyun Baek Frontiers in Medicine.2023;[Epub] CrossRef
Non-alcoholic fatty liver disease is currently the most common chronic liver disease, affecting up to 25% of the global population. Simple fatty liver, in which fat is deposited in the liver without fibrosis, has been regarded as a benign disease in the past, but it is now known to be prognostic. In the future, more emphasis should be placed on the quantification of liver fat. Traditionally, fatty liver has been assessed by histological evaluation, which requires an invasive examination; however, technological innovations have made it possible to evaluate fatty liver by non-invasive imaging methods, such as ultrasonography, computed tomography, and magnetic resonance imaging. In addition, quantitative as well as qualitative measurements for the detection of fatty liver have become available. In this review, we summarize the currently used qualitative evaluations of fatty liver and discuss quantitative evaluations that are expected to further develop in the future.
Citations
Citations to this article as recorded by
Evaluation of thyroid function in patients diagnosed with metabolic dysfunction-associated fatty liver disease: a cross-sectional study Ahmed M. Eldaba, Mona M. Watany, Galal El Din M. Elkassas, Rehab B. El sheshtawy Tanta Medical Journal.2026; 54(1): 143. CrossRef
Circulating hepatocyte-derived extracellular particles as potential biomarker of steatohepatitis progression to fibrogenesis: Exploring the impact of smoking Oumnia Masrour, Justine Morvan, Alison Rapin, Alexis Aimé, Agnès Burel, Valentine Genêt, Stéphanie Brisset, Dominique Lagadic-Gossmann, Edouard Bardou-Jacquet, Corinne Martin-Chouly Digestive and Liver Disease.2026;[Epub] CrossRef
Performance of three clinical scores for steatosis and steatohepatitis and their interaction with metabolic syndrome in obese individuals Giovani Schulte Farina, Bárbara Brambilla, Emanuelle Mendonça Pandolfo, Laura Kalil Nader Lazzaretti, Stéfano Mateus Schio Kuiava, Ana Maria Graciolli, Vitória Maria Kriger, Carlos Henrique Dal Bem Fistarol, Augusto Cardoso Sgarioni, Henrique Prataviera G World Journal of Hepatology.2026;[Epub] CrossRef
Thyroid Stimulating Hormone Levels Are Related to Fatty Liver Indices Independently of Free Thyroxine: A Cross-Sectional Study Federica Sileo, Alessandro Leone, Ramona De Amicis, Andrea Foppiani, Laila Vignati, Francesca Menichetti, Giorgia Pozzi, Simona Bertoli, Alberto Battezzati Journal of Clinical Medicine.2025; 14(7): 2401. CrossRef
The application performance of MRI-PDFF detection values of different hepatic lobes in diagnosing liver steatosis Fengjie Qiao, Yan Xue, Chen Zou, Kun Liu, Jie Yuan, Longshan Ji, Lingying Huang, Man Li, Yueqiu Gao Clinical and Experimental Medicine.2025;[Epub] CrossRef
The value of ultrasonic attenuation parameters and serum indicators on MASLD patients with liver fat degenerationality Yan Liu, Wen Kang, Jingya Su, Yin Yang, Kui Li, Juntao Yang Journal of Radiation Research and Applied Sciences.2025; 18(3): 101647. CrossRef
Quantification of liver steatosis of metabolic dysfunction-associated steatotic liver disease based on body composition analysis Toshikazu Kohira, Satoshi Oeda, Erina Eto, Yoshihito Kubotsu, Misa Norita, Kaori Inoue, Nagisa Hara, Shotaro Noge, Kenichi Tanaka, Shigenobu Yoshimura, Noriko Oza, Keizo Anzai, Yuichiro Eguchi, Cheng Han Ng, Daniel Q. Huang, Mark D. Muthiah, Atsushi Kawag Scientific Reports.2025;[Epub] CrossRef
Discovery of ultrasound-derived fat fraction as a non-invasive tool for MASLD diagnosis Huiru Jin, Mengfan Jiao, Chengxiao Yu, Tingting Ren, Qingling Chen, Zixing Dai, Erfu Xie, Longfeng Jiang, Yuwen Li European Journal of Medical Research.2025;[Epub] CrossRef
Efficacy and Safety of Sodium-Glucose Cotransporter-2 Inhibitors in
Patients with Non-Alcoholic Fatty Liver Disease: An Updated Systematic Review
and Meta-Analysis of Randomized Controlled Trials Simei Huang, Yu Xi, Yanqing Hong, Chenliang Hu Hormone and Metabolic Research.2025; 57(10): 593. CrossRef
Current Update on Nomenclature, Diagnosis, and Management of Metabolic Dysfunction–associated Steatotic Liver Disease: Radiologists’ Perspective Eri G. Osta, Florentino Saenz Rios, Sriram Jaganathan, Courtney Thomas, Eugenia Tsai, Venkateswar Surabhi, Srinivasa R. Prasad, Venkata S. Katabathina RadioGraphics.2025;[Epub] CrossRef
3D multiparametric ultrasound imaging of steatotic liver disease in a study with male rats Donghyun Lee, Jinseok Heo, Hyeonji Mun, Donghyeon Oh, Yongjoo Ahn, Chulhong Kim Nature Communications.2025;[Epub] CrossRef
Near-Infrared Fluorescent Lipid Droplet Polarity Probe for Distinguishing Different Liver Injury Diseases Xiaodong Tan, Yijia Liu, Siyu Jiang, Zhoupeng Zheng, Guoqiang Feng Chemical & Biomedical Imaging.2025;[Epub] CrossRef
Performance of noninvasive seromarkers in predicting liver fibrosis among MAFLD patients with or without viral hepatitis Chung‐Feng Huang, Po‐Cheng Liang, Chih‐Wen Wang, Tyng‐Yuan Jang, Po‐Yao Hsu, Pei‐Chien Tsai, Yu‐Ju Wei, Ming‐Lun Yeh, Ming‐Yen Hsieh, Yi‐Hung Lin, Chao‐Kuan Huang, Chia‐Yen Dai, Jee‐Fu Huang, Wan‐Long Chuang, Ming‐Lung Yu The Kaohsiung Journal of Medical Sciences.2024; 40(4): 374. CrossRef
Utilizing fully-automated 3D organ segmentation for hepatic steatosis assessment with CT attenuation-based parameters Jeongin Yoo, Ijin Joo, Sun Kyung Jeon, Junghoan Park, Soon Ho Yoon European Radiology.2024; 34(9): 6205. CrossRef
Non–small cell lung cancer and immune checkpoint inhibitor therapy: does non-alcoholic fatty liver disease have an effect? Yi Li, Bingxin Gong, Yusheng Guo, Weiwei Liu, Chao Chen, Shanshan Jiang, Feng Pan, Jiyu Song, Lian Yang, Guofeng Zhou BMC Cancer.2024;[Epub] CrossRef
Head-to-head comparison of three different US-based quantitative parameters for hepatic steatosis assessment: a prospective study Yan Zhou, Mengjin Nie, Hongyu Zhou, Feng Mao, Lin Zhao, Jianmin Ding, Xiang Jing Abdominal Radiology.2024; 49(7): 2262. CrossRef
Non-invasive Scores and Serum Biomarkers for Fatty Liver in the Era of Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD): A Comprehensive Review From NAFLD to MAFLD and MASLD Farah Abdelhameed, Chris Kite, Lukasz Lagojda, Alexander Dallaway, Kamaljit Kaur Chatha, Surinderjeet S. Chaggar, Maria Dalamaga, Eva Kassi, Ioannis Kyrou, Harpal S. Randeva Current Obesity Reports.2024; 13(3): 510. CrossRef
Maternal obesity and metabolic (dysfunction) associated fatty liver disease in pregnancy: a comprehensive narrative review Bianca M. Leca, Lukasz Lagojda, Chris Kite, Emmanouil Karteris, Eva Kassi, Harpal S. Randeva, Ioannis Kyrou Expert Review of Endocrinology & Metabolism.2024; 19(4): 335. CrossRef
Diagnosis and non‐invasive assessment of MASLD in type 2 diabetes and obesity Wah‐Kheong Chan, Salvatore Petta, Mazen Noureddin, George Boon Bee Goh, Vincent Wai‐Sun Wong Alimentary Pharmacology & Therapeutics.2024;[Epub] CrossRef
This Is What Metabolic Dysfunction–Associated Steatotic Liver Disease Looks Like: Potential of a Multiparametric MRI Protocol Anja M. Fischer, Nazim Lechea, Harvey O. Coxson Seminars in Liver Disease.2024; 44(02): 226. CrossRef
Correspondence to editorial on “Comparison of glucagon-like peptide-1 receptor agonists and thiazolidinediones on treating nonalcoholic fatty liver disease: a network meta-analysis” Hayeon Kim, Min Jeong Park, Myeong Gyu Kim, Kyungim Kim Clinical and Molecular Hepatology.2024; 30(4): 989. CrossRef
From adiposity to steatosis: metabolic dysfunction-associated steatotic liver disease, a hepatic expression of metabolic syndrome – current insights and future directions Bruno Basil, Blessing K. Myke-Mbata, Onyinye E. Eze, Augustine U. Akubue Clinical Diabetes and Endocrinology.2024;[Epub] CrossRef
Non-invasive imaging biomarkers for liver steatosis in non-alcoholic fatty liver disease: present and future Lynna Alnimer, Mazen Noureddin Clinical and Molecular Hepatology.2023; 29(2): 394. CrossRef
Application of attenuation imaging for the detection of fatty liver in potential liver donors Jae Seok Bae, Dong Ho Lee, Kyung-Suk Suh, Kwang-Woong Lee, Nam-Joon Yi, Suk Kyun Hong European Journal of Radiology.2023; 166: 110958. CrossRef
Editorial: Will MRI‐PDFF become the new standard for steatosis assessment in NAFLD? Angeliki Pappa, Tobias Wenzl Alimentary Pharmacology & Therapeutics.2023; 58(3): 364. CrossRef
Prevalence of Non-Alcoholic Fatty Liver Disease in Adult Individuals with Moderate-to-Severe Atopic Dermatitis Martina Maurelli, Paolo Gisondi, Francesco Bellinato, Alessandro Mantovani, Giovanni Targher, Giampiero Girolomoni Journal of Clinical Medicine.2023; 12(18): 6057. CrossRef