title: Alcoholic liver disease/nonalcoholic fatty liver disease index: distinguishing alcoholic from nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  The alcoholic liver disease (ALD)/nonalcoholic fatty liver disease (NAFLD) (ANI) scoring system was constructed as a response to a clinical need for avoiding the risks of liver biopsy in diagnosing the etiology of fatty liver disease. The aim of this study was to test the reliability of ANI as a noninvasive method to distinguish ALD from NAFLD.
  
  
  METHODS
  One hundred and thirty-five patients were classified into two groups, ALD and NAFLD, according to the pathohistological results. Parameters for ANI are aspartate aminotransferase, alanine aminotransferase, mean corpuscular volume, BMI, and sex. ANI was calculated using an online calculator, official site of Mayo Clinic.
  
  
  RESULTS
  ANI was significantly higher in patients with ALD than NAFLD (P<0.01). The cutoff point of ANI is -0.66. ANI greater than -0.66 indicates ALD, whereas ANI less than -0.66 yields a higher probability of NAFLD with high specificity (96.7%) and sensitivity (84.1%). The mean corpuscular volume and aspartate aminotransferase/alanine aminotransferase ratio were higher, whereas BMI was lower in patients with ALD than in NAFLD (P<0.01).
  
  
  CONCLUSIONS
  The ANI scoring system may be used for the estimation of alcoholic origin of steatosis/steatohepatitis and may help in triaging patients for liver biopsy. ANI less than -0.66 indicates NAFLD, whereas ANI greater than -0.66 confirms the alcoholic etiology, but does not exclude the contribution of associated factors toward the development of fatty liver in a Serbian population.
authors: Department of Hepatology, Clinical Centre of Serbia, Institute for Digestive Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Ivana
authors: I
authors: Cerović
authors: Dušan
authors: D
authors: Mladenović
authors: Rada
authors: R
authors: Ješić
authors: Tamara
authors: T
authors: Naumović
authors: Miloš
authors: M
authors: Branković
authors: Danijela
authors: D
authors: Vučević
authors: Vuk
authors: V
authors: Aleksić
authors: Tatjana
authors: T
authors: Radosavljević
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D015992:Body Mass Index; D016009:Chi-Square Distribution; D004796:Clinical Enzyme Tests; D003661:Decision Support Techniques; D003937:Diagnosis, Differential; D004909:Erythrocyte Indices; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D005235:Fatty Liver, Alcoholic / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D065626:Non-alcoholic Fatty Liver Disease; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D055771:Serbia; D012737:Sex Factors
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase