Diagnostic performance of serum steatosis biomarkers in Prediction of Non Alcoholic Fatty Liver Disease in Adult Asymptomatic Egyptians

Background: Non alcoholic fatty liver disease (NAFLD) is the most common liver disease involving about 25% of the world’s population. Liver biopsy is the current gold standard for the diagnosis and assessment of the severity of hepatic steatosis. However, because of its invasive nature and the risk of complications, many non invasive imaging modalities and laboratory markers were evaluated for the assessment of the hepatic steatosis. Objectives: To evaluate the diagnostic performance of noninvasive indices to predict NAFLD in Egyptian patients. Patients and methods: A cross-sectional study was conducted in a series of adult asymptomatic subjects. NAFLD was diagnosed in 100 cases by ultrasonography for whom controlled attenuation parameters (CAP) examination was done. General, anthropometric and biochemical data were collected. Fatty liver indexes (FLI), Zhejiang University index (ZJU) and hepatic steatosis index (HSI) were calculated. Roc curve analysis was used to detect the optimal cutoff of different models that predict steatosis. Results: The area under the receiver operating characteristic (AUROC) curve of the FLI, ZJU index, and HSI was 0.999, 0.929, and 0.898, respectively. The (AUROC) curve of the FLI and ZJU index were significantly higher than that of HSI (P=0.0001 and P=0.001, respectively). The optimal cut off values for the FLI, ZJU index, and HSIwere 30, 40.3, and 39.6, respectively. Conclusion: FLI, ZJU and HSI could be accurate and applicable tools for the noninvasive diagnosis of NAFLD in Egyptian patients.