Abstract
Background/Aims
To optimize management of nonalcoholic fatty liver disease (NAFLD), a simple screening
tool is necessary. In this study, we aimed to devise a simple index of NAFLD.
Study
A cross-sectional study with 10,724 health check-up subjects (5362 cases with NAFLD
versus age- and sex-matched controls) was conducted. Study subjects were randomly
assigned to a derivation cohort or a validation cohort.
Results
Multivariate analysis indicated that high serum alanine aminotransferase (ALT) to
serum aspartate aminotransferase (AST) ratio, high body mass index (BMI), and diabetes
mellitus were independent risk factors of NAFLD (all P < 0.001). Using these variables, a formula was derived by a logistic regression model:
hepatic steatosis index (HSI) = 8 × (ALT/AST ratio) + BMI (+2, if female; +2, if diabetes mellitus). HSI had an area under receiver-operating
curve of 0.812 (95% confidence interval, 0.801–0.824). At values of <30.0 or >36.0,
HSI ruled out NAFLD with a sensitivity of 93.1%, or detected NAFLD with a specificity
of 92.4%, respectively. Of 2692 subjects with HSI <30.0 or >36.0 in the derivation
cohort, 2305 (85.6%) were correctly classified. HSI was validated in the subsequent
validation cohort.
Conclusion
HSI is a simple, efficient screening tool for NAFLD that may be utilized for selecting
individuals for liver ultrasonography and for determining the need for lifestyle modifications.
Keywords
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Article info
Publication history
Published online: September 22, 2009
Accepted:
August 11,
2009
Received:
March 16,
2009
Identification
Copyright
© 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc. All rights reserved.
