•Three cross-sectional cohorts of liver biopsy-proven chronic liver disease patients were enrolled, including 1417 chronic hepatitis B (CHB) patients from 10 different medical centers, 106 non-alcoholic steatohepatitis patients, and 143 patients with autoimmune-related liver diseases. Another longitudinal cohort of 14 entecavir treatment patients was also included.
•The ROC curve was employed to explore the diagnostic value of LSM.

•In CHB patients, LSM value ascended with the increased severity of liver necroinflammation in patients with the same fibrosis stage.
•Such positive correlation between LSM and liver necroinflammation was also found in non-alcoholic steatohepatitis and autoimmune-related liver diseases populations.
•The ROC curve exhibited that LSM could identify moderate and severe inflammation in CHB patients (area under the ROC curve as 0.779 and 0.838) and in non-alcoholic steatohepatitis patients (area under the ROC curve as 0.826 and 0.871), respectively.
•Such moderate diagnostic value was also found in autoimmune-related liver diseases patients.
• In the longitudinal entecavir treated CHB cohort, a decline of LSM values was observed in parallel with the control of inflammematory activity in liver.