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A noninvasive approach to assess risk of advanced liver fibrosis

In many cases, liver disease progression can lead to the development of fibrosis, cirrhosis, and other complications. That’s why the American Association for the Study of Liver Diseases recommends the Liver Fibrosis, Fibrosis-4 (FIB-4) Index as a noninvasive approach to identify patients with a high likelihood of advanced fibrosis.1

The FIB-4 Index can assist you in determining which patients need:

  • Additional assessment of liver disease
  • Referral to a specialist

The easy-to-order, noninvasive Liver Fibrosis, Fibrosis-4 (FIB-4) Index from Quest Diagnostics yields a single score by combining:

  • Patient age (years)
  • Aspartate aminotransferase (AST)
  • Alanine aminotransferase (ALT)
  • Platelet count (PLT)

Change the course of NASH with risk identification and prompt intervention

We’re committed to supporting you with the information you need to get a clearer picture of liver disease. Rely on our FIB-4 Index to help inform the treatment decisions that can improve outcomes.

FIB-4 Index interpretation information for patients with NAFLD2

Which patients should be tested?

Patients at risk for NASH should be tested, including those with any of the following:3

  • History of chronic elevation of AST or ALT
  • Type 2 diabetes with 1 additional component of metabolic syndrome 
  • 3 components of metabolic syndrome
  • History of fatty liver identified by any radiologic modality or liver biopsy

This information is provided for informational purposes only, and is not intended as medical advice. A physician’s test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.




  1. Chalasani N, Younossi Z, Lavine, J, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):335-336. doi:10.1002/hep.29367
  2. Kumar R, Teo EK, How CH, et al. A practical clinical approach to liver fibrosis. Singapore Med J. 2018;59(12):628-633. doi:10.11622/smedj.2018145
  3. Younossi ZM, Corey KE, Alkhouri N, et al. Clinical assessment for high-risk patients with non-alcoholic fatty liver disease in primary care and diabetology practices. Aliment Pharmacol Ther. 2020;52:513–526. doi:10.1111/apt.15830

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