What is a normal sMAF-5 score?

Anything below 0. In that band fibrosis is unlikely, which is the question the score answers best, and unlike FIB-4 the cut-off is the same at every age. Most people screened land there: about 62 in 100 in the study that introduced the score.

My score is between 0 and 1. What happens now?

The middle band means the score has not decided, and about 14 in 100 people land there. The usual next step is a more specific test: transient elastography, which measures liver stiffness with a probe. Which test depends on why the question came up, so it is a decision to make with a doctor.

How is sMAF-5 different from FIB-4?

Different inputs, and better performance. FIB-4 reads your age, two enzymes and your platelets. sMAF-5 reads your BMI, your sex, your diabetes status, one enzyme and your platelets. On the same people it reached an area under the curve of 0.803 against FIB-4's 0.667, and it needs no age-adjusted cut-off because it has no age term.

Why does my platelet count matter for my liver?

As scarring stiffens the liver, pressure rises in the portal vein and the spleen retains more platelets, so the count in your blood falls. That drop appears before many other signs, which is why it carries real weight in the formula.

Can I use sMAF-5 if my liver enzymes are normal?

Yes, and this is the part worth knowing: fibrosis is common with a normal AST, particularly with type 2 diabetes. Normal enzymes do not rule scarring out, and the score still reads your BMI, your diabetes status and your platelet count, which is where most of its signal sits.

Do I need a waist measurement?

No, and that is the whole point of the simplified version. The original MAF-5 needs a waist circumference. sMAF-5 replaces it with your sex and reaches almost the same accuracy, so a blood report and a bathroom scale are enough.

sMAF-5 calculator

sMAF-5 estimates how likely it is that your liver already carries fibrosis. It reads five things a routine check-up produces: your height and weight, your sex, whether you have type 2 diabetes, one liver enzyme and your platelet count. No waist measurement needed.

Calculate your sMAF-5 score

Sex

Height

Weight

Your height and weight give the BMI the score uses. The model stops counting below a BMI of 25, so it treats anything under that as 25.

Type 2 diabetes

Diagnosed type 2 diabetes, whether or not it is treated. This is the heaviest single term in the score, worth more than the entire width of the middle band, which is why nothing here is preselected.

AST

U/L

Platelet count

Tsd/µl

Both values are on a standard check-up. German reports write AST, often also GOT.

In thousands per microlitre, which is how German labs report platelets. Tsd/µl, /nl and 10³/µl all mean the same number. A normal count reads as roughly 150 to 400. A report in whole cells per microlitre means the same thing: 250,000 per microlitre is 250.

sMAF-5 sorts adults with metabolic risk factors into those who need a closer look at their liver and those who do not. It does not apply during an acute hepatitis, or when your platelet count is low or high for a reason of its own.

The calculation runs in your browser and nothing you enter is sent to us or stored. sMAF-5 decides who needs further testing. It does not measure your liver.

The score

What sMAF-5 is

sMAF-5 is a fibrosis risk score: five routine values combined into one number that estimates how likely liver fibrosis is. It is the simplified version of MAF-5, published in 2024, which has become one of the best performing non-invasive tests for finding liver scarring in people who had no idea they were at risk.

The simplification is the waist. MAF-5 needs a waist circumference plus a term that multiplies waist by BMI, which no blood report carries and few people can supply from memory. sMAF-5 drops both and puts sex in their place, at almost no cost: the two scores agreed almost perfectly, and sMAF-5 reached an area under the curve of 0.803 against MAF-5's 0.808.

The comparison that matters is with FIB-4, the score most guidelines still put first. On the same people, for the same question, sMAF-5 reached 0.803 and FIB-4 reached 0.667. sMAF-5 also has no age term, so it needs no age-adjusted cut-off of the kind FIB-4 has to apply from 65 onwards.

What it reads

The five things the score uses

Three of the five you already know without a blood test. The other two, one enzyme and your platelet count, are on any standard check-up.

BMI

Your height and weight, combined into a BMI. It is the largest of the routine terms, and it only counts upwards from 25: the model was fitted in people with metabolic dysfunction, so it treats a BMI of 21 and a BMI of 25 as the same input.

Type 2 diabetes

A diagnosis of type 2 diabetes adds a fixed amount, and it is the heaviest single term in the formula: more than the entire width of the middle band. That is not arbitrary. Fibrosis is far more common in people with type 2 diabetes, often with completely normal liver enzymes.

Sex

Men score slightly higher than women on otherwise identical values. It is the smallest term in the score, and it is the one that replaced the waist measurement: sex carries part of the same information about where body fat sits.

AST

Aspartate aminotransferase, written AST or GOT on German reports. It rises when liver cells are damaged, and it enters the score through a logarithm, so what counts is the order of magnitude: going from 20 to 40 adds about as much as going from 40 to 80.

Platelet count

The count falls as scarring progresses, because a stiffening liver raises the pressure in the portal vein and the spleen holds more platelets back. It subtracts from the score, so a lower count raises it.

What each band means in numbers

A woman of 165 cm and 90 kg with an AST of 30 and a platelet count of 220 scores 0.92, in the middle band. Add type 2 diabetes for the same woman and she scores 3.26, which is high risk: that one answer is worth more than the entire width of the middle band. The rates below are the ones the authors observed in each band.

What each band means in numbers
Risk band	sMAF-5 score	Signs of fibrosis on a scan	Liver-related events
Low risk	below 0.00	3.4%	0.6%
Intermediate	0.00 to 1.00	9.2%	0.7%
High risk	1.00 and above	27.7%	3.2%

The third column is the share of people in that band whose measurement showed a liver stiffness of 8 kPa or more, among the 6,191 adults the score was developed in. The fourth is the share who went on to have a liver-related event, from 12,330 patients at 16 specialist centres. Both are rates in a population, not your personal risk.

Who the score applies to

sMAF-5 was built to triage adults with metabolic risk factors: the population the guidelines say to screen, and the one in which fibrosis is most often missed. Outside that setting it answers a question nobody asked.

It applies if

You are an adult with type 2 diabetes, obesity, or another metabolic risk factor such as high blood pressure or a fatty liver seen on a scan
You have a recent AST and a recent platelet count, or you can get both from a single blood draw
Your values are at their usual level rather than in the middle of a flare

It does not apply if

You have an acute hepatitis or any illness that has sent your enzymes into the hundreds: the score reads chronic, stable values
Your platelet count is low or high for a reason of its own, such as a blood disorder, a recent infection or a medication that affects it
You already have a diagnosis of cirrhosis: the question sMAF-5 asks is settled
You are pregnant, or you are under 18

sMAF-5 also says nothing about the cause. Alcohol, metabolic fatty liver disease, viral hepatitis and autoimmune liver disease all raise the same score, and what to do about them differs completely. That is a reason to read the result with a doctor, not a reason to ignore it.

The units, the way German labs report them

AST goes in as units per litre, which is how every German laboratory reports it. Your report may name it AST, the international convention, or GOT, the older one that is still common in Germany. It is the same enzyme under either name.

Platelets are where a mix-up is easy. German reports give the value in thousands per microlitre, written as Tsd/µl, /nl or 10³/µl, so a normal result is 150 to 400. The same value in whole cells is 150,000 to 400,000 per microlitre. Enter 250, not 250,000: platelets are subtracted in this score, so a value in the thousands would drive it to roughly minus 1,700 and indicate a reassuringly low risk. This calculator rejects the figure instead.

One check-up, five values

Your height, weight and diabetes status you already have. The AST comes from the liver panel and the platelet count from the blood count, both standard on a comprehensive check-up, so if you had one recently the numbers are already in your file.

The limits

What sMAF-5 cannot tell you

sMAF-5 is good at deciding who needs a scan. It is poor at describing what is happening inside one person's liver.

It is a screening score, not a measurement

Even in the highest band most people turn out not to have significant fibrosis: 28 in 100 did, which means 72 in 100 did not. A high score is a reason for the next test, and that next test is a scan rather than another calculation.

The evidence is new

The parent score, MAF-5, has been validated in tens of thousands of people across several countries. The simplified version was presented at a conference in May 2026 and has not yet appeared as a full journal article, so it carries less weight than FIB-4's twenty years of use.

It stops looking below a BMI of 25

The BMI term is floored at 25, because the score was developed in people with metabolic dysfunction. A lean person with liver disease is exactly the case it was not fitted for, and a low score there rules out less than the same score at a BMI of 32.

It looks for scarring, not fat or inflammation

A liver can be substantially fatty, or inflamed, with an sMAF-5 well below 0. The score is built to notice the late structural change, so a low result says nothing about the earlier stages that lead there.

One reading, or the trend

sMAF-5 estimates. Repeat panels show.

The Ahead Health Prevention Starter blood test measures 67 biomarkers from a single blood draw: liver enzymes, platelets, metabolic and inflammatory markers, with a personal report you can actually read and a prevention team that goes through it with you. It answers the question sMAF-5 raises but cannot settle: where your own values are heading.

Go to the Prevention Starter blood test See all prices

A check-up is prevention, not treatment. It does not replace care from your own doctor.

67 biomarkers from a single blood draw
Liver enzymes and platelets that you can measure again later and compare
GGT, metabolic and inflammatory markers, which sMAF-5 does not read
A personal report and an action plan, reviewed by physicians
A prevention team you can ask about your result

Frequently asked questions

Other calculators

Free tools that ask a different question about the same body.

Get the values, then track them

A blood check-up gives you the AST and the platelet count sMAF-5 needs, plus the markers it does not read: ALT, GGT, metabolic markers, inflammation and organ function, reviewed by physicians.

Source

van Kleef LA, Jin X, Yip TC and colleagues, Simplified metabolic dysfunction associated fibrosis-5 (sMAF-5) score to identify at-risk liver fibrosis and to predict prognosis, Journal of Hepatology 2026, volume 84 supplement 1, pages S621 to S622, presented at the EASL Congress 2026. The parent score is van Kleef LA and colleagues, Metabolic dysfunction associated fibrosis 5 (MAF-5) score predicts liver fibrosis risk and outcome in the general population with metabolic dysfunction, Gastroenterology 2024, volume 167, pages 357 to 367. The coefficients used here are the ones the authors publish in their own calculator at maf5.com.

This calculator provides general health information and is not a medical diagnosis. It does not replace an assessment by a doctor. If your result worries you, or if you have symptoms, speak to a physician.