Blood Tests for Age-Related Changes in Hepatic Function

Available Serum Biomarkers That Account for Age

• The American Association for the Study of Liver Diseases recommends using serum biomarker panels that incorporate age as a parameter, such as FibroTest®, Forns Index, Enhanced Liver Fibrosis (ELF) score®, Fibrosis Probability Index (FPI), Hepascore®, FibroMeter®, Virahep-C model, Zeng score, and FIB-4, to assess liver fibrosis and function in aging patients 1
• The European Association for the Study of the Liver suggests using the NAFLD Fibrosis Score (NFS), which includes age, BMI, diabetes status, AST/ALT ratio, platelet count, and albumin, to assess liver fibrosis in patients with non-alcoholic fatty liver disease 3

Clinical Application of Age-Adjusted Tests

• The American Gastroenterological Association recommends using age-incorporating algorithms like FIB-4 or NAFLD Fibrosis Score to risk-stratify patients with suspected liver disease, with FIB-4 <1.3 (or <2.0 for those >65 years) or NFS <-1.455 (or <0.12 for those >65 years) indicating low risk of advanced fibrosis 3

Limitations and Caveats

• The American Association for the Study of Liver Diseases notes that none of these tests are liver-specific, and results may be influenced by changes in clearance and excretion of individual parameters, requiring critical interpretation to avoid false positive or false negative results 1