Abstract
Background and Aims
The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing in young
populations. However, there are inadequate data regarding diagnosis of NAFLD. We aimed
to validate three scoring systems against a previous standard of suprailiac skinfold
thickness for diagnosing NAFLD in population-based adolescents.
Methods
Seventeen-year-old adolescents (n = 899), participating in the Raine Study, attended a cross-sectional follow-up. NAFLD
was diagnosed using liver ultrasound. Scores for Fatty liver index (FLI), Hepatic
Steatosis Index (HSI) and Zhejiang University index (ZJU index) were calculated. Diagnostic
accuracy of these diagnostic tests was evaluated through discrimination and calibration.
Results
NAFLD was diagnosed 9% in males and 15% in females. The three scoring systems demonstrated
better discrimination performance for NAFLD in males (AUC was FLI:0.82, HSI: 0.83
and ZJU index: 0.83) compared to females (AUC was FLI: 0.67, HSI: 0.67 and ZJU index:
0.67). Suprailiac skinfold performed better than the scoring systems (overall AUC:
0.82; male AUC:0.88; female AUC:0.73). FLI had best calibration performance.
Conclusion
Suprailiac skinfold thickness was a better predictor of ultrasound-diagnosed NAFLD
than the three diagnostic scoring systems investigated. The higher performance characteristics
of the algorithmic scoring systems in males compared with females may have implications
for use in population assessments.
Keywords
Abbreviations:
ALT (alanine aminotransferase), AST (aspartate aminotransferase), AUC (area under curve), BMI (body mass index), CITL (calibration in the large for model), FLI (fatty liver index), GGT (gamma-glutamyl transferase), HSI (hepatic steatosis index), IQRs (interquartile ranges), LDL-C (low-density lipoprotein cholesterol), NAFLD (nonalcoholic fatty liver disease), NPV (negative predictive value), PPV (positive predictive value), RCT (randomized controlled trial), ROC (receiver operating characteristic), SFT (skinfold thickness), SLOPE (calibration slope for model), TG (triglycerides), WC (waist circumference), ZJU index (Zhe Jiang University index)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 14, 2020
Accepted:
November 29,
2020
Received:
July 28,
2020
Identification
Copyright
© 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
