ELF Score Slide 1

Enhanced Liver Fibrosis (ELF™) Score

$310 CAD

Twenty percent of patients with NAFLD progress to nonalcoholic steatohepatitis (NASH), which is strongly linked to liver fibrosis and can lead to cirrhosis, liver transplantation, or even death.¹ Furthermore, 1 in 5 patients with advanced fibrosis progress to cirrhosis in 2.5 years.2 A simple blood test can determine the risk of NASH progression


1. Younossi Zm, Koenig A, Abdelatif D, Et Al. Global Epidemiology Of Nonalcoholic Fatty Liver Disease-Meta-Analytic Assessment Of Prevalence, Incidence, And Outcomes. Hepatology. 2016;64(1):73-84. Doi:10.1002/Hep.28431

2. Sanyal Aj, Harrison Sa, Ratziu V, Et Al. The Natural History Of Advanced Fibrosis Due To Nonalcoholic Steatohepatitis: Data From The Simtuzumab Trials. Hepatology. 2019;70(6):1913-1927. Doi:10.1002/Hep.30664


  • Non-invasive sample collection
  • Confidential results in 7 to 10 days

Collection method

  • Blood sample – visit an Alpha Labs Patient Service Centre

About this test

Using a single, nonfasting tube of serum, the ELF Score is obtained from an algorithm that incorporates 3 direct markers of fibrosis:

  • Hyaluronic acid (HA)

     Extracellular matrix (ECM) component

  • Procollagen III N-terminal peptide (PIIINP)

      ECM component

  • Tissue inhibitor of metalloproteinase 1 (TIMP-1)

     Inhibits breakdown of collagen III

The score result identifies risk of disease progression to cirrhosis or LREs.

ªIn the Mid group, the risk of disease progression is similar to the pre-test risk. Pre-test risk refers to the likelihood of disease progression in the overall intended use population without considering the ELF Score. Results should always be interpreted in c

People with the following conditions are likely to have NAFLD and should be considered at high risk and assessed for liver fibrosis:

  • Obesity and/or features of metabolic syndrome
  • Prediabetes or type 2 diabetes
  • Hepatic steatosis on any imaging study and/or persistently elevated plasma aminotransferase levels (over 6 months)
ELF Score Stat Image

It is estimated that by 2030, NASH will be the #1 most frequent reason for liver transplants in the U.S.

Source: Charlton Mr, Burns Jm, Pedersen Ra, Et Al. Frequency And Outcomes Of Liver Transplantation For Nonalcoholic Steatohepatitis In The United States. Gastroenterology. 2011;141(4):1249-1253. Doi:10.1053/J.Gastro.2011.06.061