Diagnostic significance of clinical and laboratory indices in predicting non-alcoholic fatty liver disease during screening studies

• Published in: Terapevtic̆eskii arhiv Vol. 93; no. 8; pp. 883 - 889
• Main Authors: Nosov, Aleksandr E., Zenina, Mariia T., Gorbushina, Olga Y., Baidina, Anastasiia S., Vlasova, Elena M., Alekseev, Vadim B.
• Format: Journal Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 15-08-2021
• Subjects: insulin resistance; non-alcoholic fatty liver disease; steatosis indexes; ultrasound scanning of the liver
• ISSN: 0040-3660; 2309-5342
• DOI: 10.26442/00403660.2021.08.200973

Aim. To study the significance of clinical and laboratory non-invasive indexes along with the insulin resistance index when carrying out diagnostic assessment of non-alcoholic fatty liver disease (NAFLD) during screening examinations.
Materials and methods. The study involved 348 employees working at oil-production enterprises. An ultrasound scanning of the liver was carried out to assess the criteria of NAFLD. The following indexes were calculated: fatty liver index (FLI), hepatic steatosis index (HSI), lipid accumulation products (LAP), and homeostasis model assessment of insulin resistance (HOMA1-IR). The prognostic significance of these indexes in relation to the probability of NAFLD diagnosis based on ultrasound data was studied using single-factor and multi-factor logistic regression models followed by ROC-analysis.
Results. The FLI, HSI, and HOMA1-IR indexes in single-factor logistic regression models showed a high statistical significance when carrying out diagnostic assessment the NAFLD with good model calibration capability. The percentage of correct binary classification regards the presence/absence of NAFLD amounted to 82.4% for FLI, 79.7% for HSI, and 72.7% for HOMA1-IR (p0.001). According to the ROC-analysis, the area under the curve (AUC) by the NAFLD diagnostic assessment was 0.917 (95% CI 0.8890.945); 0.880 (95% CI 0.8460.915) and 0.849 (95% CI 0.7640.934), respectively. The multi-factor logistic regression model with the inclusion of FLI and HOMA1-IR 72.7% enabled us to achieve the correct binary classification in terms of NAFLD in 84.2% of cases. When it comes to the ROC-analysis, considering the probabilities predicted in the multi-factor logistic model as the test variable and NAFLD in ultrasound examination as the state variable, it was possible to set the value of AUC 0.933 (95% CI 0.8820.985).
Conclusion. The studied clinical and laboratory indexes (FLI, HSI, HOMA1-IR) have a high diagnostic significance regarding NAFLD diagnosed using ultrasonographic criteria. The application of the proposed two-factor logistics model makes it possible to predict the presence of NAFLD when examining a large number of patients, without involving additional ultrasound diagnostics specialists in order to use medical resources rationally.