Plasma IGFBP7 improves risk reclassification for liver-related outcomes: Insights from proteo-transcriptomic profiling

This study demonstrates that IGFBP7 is both a biomarker of advanced liver fibrosis and a strong long-term predictor of liver-related outcomes. The integration of IGFBP7 with conventional non-invasive tests enhances the refinement of risk prediction. Among individuals with low CLivD scores, those with high IGFBP7 levels had a substantially increased incidence of liver-related outcomes (2.5%), while low IGFBP7 levels were associated with favorable outcomes even in high CLivD groups (0.8%). This enables more precise identification of patients who may benefit from early referral <i>vs.</i> those suitable for reduced monitoring, potentially optimizing care pathways in resource-limited settings. Moreover, IGFBP7 demonstrated consistent applicability across all categories of steatotic liver disease defined by the current Delphi consensus framework, underscoring its broad clinical utility.