NAFL screening score: A basic score identifying ultrasound-diagnosed non-alcoholic fatty liver

Clin Chim Acta. 2017 Dec:475:44-50. doi: 10.1016/j.cca.2017.09.020. Epub 2017 Sep 28.

Abstract

Background: Several non-invasive diagnostic scores for non-alcoholic fatty liver (NAFL) have been developed, but the clinical application is limited because of their complexity.

Aim: To develop and validate an easy-to-calculate scoring system to identify ultrasound-diagnosed NAFL.

Methods: 48,489 patients from 2 centers were included in this study. Multivariable logistic regression models were employed for model development. Ultrasonography was applied to diagnose NAFL. The selected variables were assigned an integer score proportional to the estimated coefficient from the logistic regression analysis, namely NAFL Screening Score (NSS). The ability of the NSS to identify NAFL was assessed by analyzing the area under the receiver operating characteristic curve (AUROC) and was tested in an independent validation cohort. Additionally, the performance of NSS was compared with existing models.

Results: NSS was developed as a basic score comprising of age, body mass index (BMI), triglyceride (TG), ALT/AST, fasting plasma glucose (FPG) and uric acid (UA) in both sexes. NSS showed a relatively good discriminative power (AUROC=0.825 for males, 0.861 for females in the validation cohort) in comparison with other models. The optimal cut-off point was 32 for males and 29 for females.

Conclusion: We developed and validated NSS, an easy-to-use score sheet identify ultrasound-diagnosed NAFL. NSS may be clinically useful for initial diagnosing NAFL.

Keywords: Diagnostic score; Easy-to-calculate; Non-alcoholic liver fat; Uric acid.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Alanine Transaminase / blood*
  • Area Under Curve
  • Aspartate Aminotransferases / blood*
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Body Mass Index*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Liver / diagnostic imaging*
  • Liver / metabolism
  • Liver / pathology
  • Logistic Models
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / blood*
  • Non-alcoholic Fatty Liver Disease / diagnostic imaging
  • Non-alcoholic Fatty Liver Disease / pathology
  • ROC Curve
  • Severity of Illness Index
  • Triglycerides / blood*
  • Ultrasonography
  • Uric Acid / blood

Substances

  • Biomarkers
  • Blood Glucose
  • Triglycerides
  • Uric Acid
  • Aspartate Aminotransferases
  • Alanine Transaminase