New Blood Test Score Enhances Detection of Alcohol-Related Liver Disease

Researchers at the University of California San Diego School of Medicine have introduced a new blood test score that significantly enhances the identification of alcohol-related fatty liver disease. This development addresses a critical gap in routine medical care, where the distinction between liver injury from alcohol and other metabolic causes is often overlooked. The findings were published in the online edition of Gastroenterology on February 25, 2026.

The tool, known as the MetALD-ALD Prediction Index (MAPI), utilizes five standard laboratory values that are typically collected during most primary care and liver clinic visits. By analyzing these values, MAPI can assess the likelihood that a patient with fatty liver disease is experiencing liver injury due to alcohol consumption, even if the patient has underreported their alcohol intake.

In a comprehensive study that included more than 500 adults in the San Diego area and approximately 1,800 individuals in Sweden, MAPI demonstrated superior performance compared to commonly used blood tests. This capability allows clinicians to determine when further alcohol testing is warranted, ultimately facilitating earlier intervention and more personalized care.

Fatty liver disease affects nearly one in three adults globally, and its causes vary widely. While many patients exhibit metabolic factors, such as obesity or diabetes, others may suffer from liver damage exacerbated by alcohol. The challenge remains that patients often underreport their alcohol consumption due to societal stigma, leading healthcare providers to miss the role that alcohol plays in disease progression. Undetected alcohol-related liver damage can quietly advance over years, potentially resulting in hospitalization and preventable fatalities.

The research team highlighted the need for accessible testing methods. The most accurate alcohol test, phosphatidylethanol (PEth), is reliable but may be costly or unavailable in numerous healthcare settings. MAPI serves as an effective screening tool that helps clinicians decide when PEth testing is necessary, thereby making liver disease evaluations more accessible and facilitating earlier interventions with fewer complications.

This innovation is particularly beneficial in primary care settings, where most fatty liver disease cases are first diagnosed. MAPI not only aids in clinical assessments but also enhances patient counseling by providing a clearer understanding of their condition. Improved transparency has the potential to reduce stigma, empower patients, and encourage honest discussions about alcohol use.

“Our goal was to build something practical,” stated Federica Tavaglione, MD, PhD, the study’s first author. “These lab values are already part of standard care, so MAPI can be implemented immediately without adding cost or complexity for clinics.”

The study was conducted at the UC San Diego MASLD Research Center, which is recognized for its leadership in research on metabolic and alcohol-associated liver diseases. Researchers aim to employ MAPI in large observational studies and future clinical trials to broaden its impact on liver disease detection and improve patient care on a larger scale.