Interactive effects of platelet-to-lymphocyte ratio and FIB-4 index for risk stratification of liver fibrosis in metabolic dysfunction-associated steatotic liver disease: performance assessment comparing interactive models with traditional composite scores.

Among the 358 patients, 168 (46.9%) had significant fibrosis.

Platelet-to-lymphocyte ratio was positively correlated with the FIB-4 index ( r = 0.542, p < 0.001), and this correlation strengthened with increasing fibrosis severity.

Compared to the APRI-FIB-4 composite score, the interaction model significantly improved reclassification (net reclassification index: 0.142, p = 0.008) and discrimination (integrated discrimination improvement: 0.067, p = 0.003).