VALIDATION OF FATTY LIVER INDEX FOR NONALCOHOLIC FATTY LIVER DISEASE IN PAKISTANI ADULTS

Abstract

Objective: To compare the diagnostic accuracy of fatty liver index (FLI) with abdominal ultrasonography (USG) for the nonalcoholic fatty liver disease.

Study design: Cross sectional analytical study.

Place & duration of study: PNS SHIFA hospital Karachi, from August 2015 to July 2016.

Materials and Methods: Adults of either gender aged more than 20 years who reported to radiology department for USG abdomen were consecutively inducted. Patients with diabetes mellitus, hypertension, chronic liver disease, those with significant alcohol intake and taking lipid lowering drugs were excluded. Anthropometric and biochemical data were collected by a standard protocol. NAFLD was diagnosed by hepatic USG. FLI being an index test was compared with USG taken as reference standard. The accuracy and cut-off point of the FLI to detect NAFLD were evaluated by area under the receiver operator characteristic curve (AUC) and the maximum Youden index analysis, respectively.

Results: NAFLD was present in 72(34%) out of 210 subjects. The AUC of the FLI for NAFLD was 0.876 (95% confidence interval: 0.818–0.916), and larger than that of its each individual component [0.787 (0.722–0.853), 0.739 (0.661–0.816), 0.754 (0.689–0.82), and 0.774 (0.706–0.841) for waist circumference (WC), body mass index (BMI), triglyceride (TG), and γ-glutamyl transferase (GGT), respectively] (all P =0.000). The optimal cut-off point of the FLI for diagnosing NAFLD was 30 with the maximum Youden Index of 0.537, achieving a high sensitivity of 80.55% and a speciï¬city of 73.19%.

Conclusion: The FLI could accurately identify NAFLD at optimal cut-off point of 30 in Pakistani adults. 

Keywords: NAFLD, Fatty liver index, Ultrasound, Youden index, GGT, BMI.