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


METHODS
216 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.


RESULTS
An 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 > or = 60 (positive likelihood ratio = 4.3) rules in fatty liver.


CONCLUSIONS
FLI 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.
Bedogni
Giorgio
G
Centro Studi Fegato (Liver Research Center), AREA Science Park, Basovizza, Trieste, and Department of Biochemistry, Biophysics and Macromolecular Chemistry, University of Trieste, Trieste, Italy. giorgiobedogni@libero.it <giorgiobedogni@libero.it>
Bellentani
Stefano
S
Miglioli
Lucia
L
Masutti
Flora
F
Passalacqua
Marilena
M
Castiglione
Anna
A
Tiribelli
Claudio
C
D000328:Adult; D000368:Aged; D000465:Algorithms; D015992:Body Mass Index; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D014280:Triglycerides / Q000097:blood*; D014463:Ultrasonography; D005723:gamma-Glutamyltransferase / Q000097:blood*
D014280:Triglycerides; D005723:gamma-Glutamyltransferase