The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population

By G. Bedogni, S. Bellentani, L. Miglioli, F. Masutti, M. Passalacqua, A. Castiglione, C. Tiribelli. BMC Gastroenterology, 2006

2,637 citations recorded by the source corpus.

BackgroundFatty liver (FL) is the most frequent liver disease in Western countries. We used data from the Dionysos Nutrition & Liver Study to develop a simple algorithm for the prediction of FL in the general population.Methods216 subjects with and 280 without suspected liver disease were studied. FL was diagnosed by ultrasonography and alcohol intake was assessed using a 7-day diary. Bootstrapped stepwise logistic regression was used to identify potential predictors of FL among 13 variables of interest [gender, age, ethanol intake, alanine transaminase, aspartate transaminase, gamma-glutamyl-transferase (GGT), body mass index (BMI), waist circumference, sum of 4 skinfolds, glucose, insulin, triglycerides, and cholesterol]. Potential predictors were entered into stepwise logistic regression models with the aim of obtaining the most simple and accurate algorithm for the prediction of FL.ResultsAn algorithm based on BMI, waist circumference, triglycerides and GGT had an accuracy of 0.84 (95%CI 0.81–0.87) in detecting FL. We used this algorithm to develop the "fatty liver index" (FLI), which varies between 0 and 100. A FLI < 30 (negative likelihood ratio = 0.2) rules out and a FLI ≥ 60 (positive likelihood ratio = 4.3) rules in fatty liver.ConclusionFLI is simple to obtain and may help physicians select subjects for liver ultrasonography and intensified lifestyle counseling, and researchers to select patients for epidemiologic studies. Validation of FLI in external populations is needed before it can be employed for these purposes.

Subfields: Epidemiology, Hepatology, Pathology and Forensic Medicine

View Paper: https://www.semanticscholar.org/paper/7df80bb1b4e23999a7cc9105e2e792b1a56396c4

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Citations in the corpus

Epidemiology of Non-Alcoholic Fatty Liver Disease (2010, background): “We suggest to expand the number of prospective cohort studies in the general population, even if they are more expensive and difficult to handle, because they give more reliable results about the burden of disease attributable to NAFLD. The most simple, noninvasive and practical method for diagnosin”
Homozygosity for the patatin‐like phospholipase‐3/adiponutrin I148M polymorphism influences liver fibrosis in patients with nonalcoholic fatty liver disease (2010, methodology): “However, these subjects were carefully selected among a much larger pool of healthy blood donors because of normal metabolic parameters, liver enzymes, and a very low fatty liver index.(24) Another limitation is related to the relatively small number of patients, all affected by severe obesity, who ”
Non-Alcoholic Fatty Liver Disease (NAFLD) and Its Connection with Insulin Resistance, Dyslipidemia, Atherosclerosis and Coronary Heart Disease (2013, neutral): “Previously it has been shown that hypertriglyceridemia is present in up to 64% [57] and indeed triglyceride and gamma glutamyl transferase (γGT) concentration, waist circumference and BMI are among the best predictors of fatty liver disease and related co-morbidities [44,85].”
EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. (2016, positive): “[1] Bohte AE, van Werven JR, Bipat S, Stoker J.”
Age-related changes in total and regional fat distribution. (2009, neutral): “Regardless, studies tend to report a stronger association between liver fat and obesity than with age (Bedogni et al., 2005, 2006; Fan et al., 2005; Machann et al., 2005b).”
A position statement on NAFLD/NASH based on the EASL 2009 special conference. (2010, background): “Available tests cannot be compared for their diagnostic performance as they have been validated against different standards: ultrasonography [109], liver biopsy [110], or MRI [82].”
Fructose and Sugar: A Major Mediator of Nonalcoholic Fatty Liver Disease (2018, positive): “In addition to the aforementioned clinical studies, Figure 1 shows the rise in documented NAFLD prevalence in the National Health and Nutrition Examination Survey (NHANES) database, using a validated, noninvasive measurement (59), the United States Fatty Liver Index (US FLI), in relationship to the ”