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What’s going on here?

China’s yuan is on its best run in years, but the country’s central bank already looks like it’s trying to tap the brakes.

What does this mean?

The onshore yuan is on track for a fourth straight monthly gain versus the dollar – its longest winning streak in four years – after touching a 13‑month high. Both the onshore and offshore yuan are up solidly this year, by about 3.2% and 3.7% against the dollar as of early Friday. But traders say that strength doesn’t quite square with China’s softer backdrop, with recent data pointing to weak domestic demand and factory activity still under scrutiny. The rally is mostly riding on a broadly weaker dollar, which is heading for its worst week in four months, with thin US Thanksgiving trading exaggerating moves. That leaves the People’s Bank of China in a tricky spot, and it’s pushing back by setting its daily midpoint fix weaker than market models suggest for a second day in a row, using its 2% trading band to lean against further gains.

Why should I care?

For markets: Currency moves are shouting more than the economy is whispering.

The yuan’s climb is coming even as China’s money markets loosen, with the volume‑weighted overnight repo rate down to around 1.29% – its lowest level in more than two years. Easier cash conditions and ongoing policy support usually point to a weaker, not stronger, currency, which is why the PBOC seems wary of letting the yuan run too far. Morgan Stanley reckons the real driver from here will be the dollar and the Fed, and expects the yuan to gradually strengthen toward 7.0 per dollar by mid‑2026, before easing slightly to roughly 7.05 by the end of that year. In the short term, though, traders are zeroing in on November factory data and the upcoming Central Economic Work Conference – two events that could jolt Chinese stocks, bonds, and regional currencies.

The bigger picture: A stronger yuan does not mean a stronger China just yet.

A firmer yuan can help tamp down imported inflation and project confidence, but it can also squeeze exporters at a time when China’s recovery is still fragile. Recent indicators have underscored weak domestic demand, right as policymakers try to shore up growth with targeted easing and looser funding conditions. That tension helps explain why the PBOC seems comfortable with relative currency stability, but not with an unchecked rally driven mainly by a wobbly dollar. For global investors and governments, how China manages that balance between growth, currency control, and capital flows into 2025 and 2026 will influence trade patterns, commodity demand, and how other Asian central banks steer their own exchange rates.

A newly validated noninvasive scoring tool has shown superior performance in identifying metabolic dysfunction–associated steatohepatitis (MASH) patients with advanced liver fibrosis, offering a potential step forward in reducing reliance on biopsy and improving risk stratification in the most common chronic liver disease worldwide.¹

The findings, published by researchers in Spain in Biomarker Research, confirmed that the BMP8A Fibrosis Score (BFS) more accurately classifies patients with severe fibrosis than several widely used diagnostic algorithms while eliminating the grey-zone results that often complicate clinical decision-making.

Although liver biopsy remains the gold standard for staging fibrosis, it is invasive, costly, and impractical to perform routinely. Existing noninvasive scoring systems, such as the Fibrosis-4 (FIB-4) Index, NAFLD Fibrosis Score (NFS), Hepamet Fibrosis Score (HFS), and AST-to-Platelet Ratio Index (APRI), are widely used but have limitations, explained the researchers. Many patients fall into intermediate “grey zones,” where results are inconclusive and further testing is required. Variability in sensitivity and specificity across clinical settings further limits their reliability.

Researchers previously identified circulating bone morphogenetic protein 8A (BMP8A) as a promising biomarker after observing that serum levels rise progressively with fibrosis severity.² Building on these earlier findings, the team developed the BFS, which integrates BMP8A concentration with patient age and platelet count. In its initial derivation study, BFS showed encouraging accuracy in distinguishing advanced fibrosis in patients with biopsy-confirmed MASH.

To validate the score in an independent population, investigators analyzed serum BMP8A levels in 302 patients with MASH across 7 university hospitals in Spain. Of these, 171 had no or mild fibrosis (F0-F2), and 131 had advanced fibrosis (F3–F4). Serum BMP8A concentrations were significantly higher in patients with advanced fibrosis, averaging 339.6 pg/mL compared with 230.5 pg/mL in earlier-stage disease, with a clear stepwise increase across fibrosis stages.

Diagnostic accuracy was assessed using area under the receiver operating characteristic (AUROC) curves and compared directly against other noninvasive scores. BMP8A alone had an AUROC of 0.669, while the composite BFS achieved 0.750, outperforming FIB-4 (0.747), HFS (0.723), APRI (0.706), and NFS (0.650). Although not dramatically higher, BFS delivered the strongest overall accuracy and, crucially, provided a single cutoff value of 0.46. Unlike competing scores that rely on dual thresholds and create indeterminate zones, BFS eliminates ambiguous results.

Using that cutoff, BFS correctly classified 70.9% of patients with advanced fibrosis, with a specificity of 80.7% and a positive predictive value (PPV) of 69.7%. Its negative predictive value (NPV) of 71.5% and likelihood ratio profile (LR+ 3.0; LR– 0.5) supported both ruling in and ruling out advanced disease. In contrast, FIB-4 at its commonly used ≥2.67 threshold correctly identified only 63.6% of advanced cases and misclassified a substantial proportion due to false negatives and indeterminate outputs. HFS and APRI performed similarly or worse, especially when restricted to higher cutoffs, and NFS showed the lowest diagnostic utility in this cohort.

By eliminating grey-zone classifications, BFS categorized 63.9% of the cohort as F0–F2 and 36.1% as F3–F4, providing a decisive result in every case. The authors noted that this feature may be particularly important in clinical trial screening, where rapid and reliable fibrosis stratification is required without exposing patients to unnecessary biopsy. The group noted that the multicenter design of their study strengthens generalizability, reflecting diverse patient populations and real-world variability across laboratories and hospitals.

However, the researchers acknowledged limitations of their findings. Because BFS requires ELISA-based measurement of serum BMP8A, it may be costlier and less accessible than scores derived exclusively from routine laboratory data.

“This drawback parallels other specialized biomarkers, such as MACK3, which improve accuracy but require additional assays, sometimes not available in commercial laboratories, as is the case with BFS,” wrote the researchers.

They emphasized that additional validation in broader populations, inter-laboratory reproducibility studies, and commercial assay availability will be necessary before widespread adoption. They also noted that BFS, like other biomarkers, should be interpreted alongside imaging tools such as elastography, which continue to play an expanding role in fibrosis assessment.

References

1. Isaza SC, Fernández-García CE, Rojo D, et al. Validation of BMP8A fibrosis score to identify patients with metabolic dysfunction-associated steatohepatitis with advanced liver fibrosis. Biomark Res. Published online November 19, 2025. doi:10.1186/s40364-025-00862-3

2. Marañón P, Isaza SC, Fernández-García CE, Rey E, Gallego-Durán R, Montero- Vallejo R, et al. Circulating bone morphogenetic protein 8A is a novel biomarker to predict advanced liver fibrosis. Biomark Res. 2023;11(1):46. doi:10.1186/s40364-023-00489-2