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Validation of fatty liver disease scoring systems for ultrasound diagnosed non-alcoholic fatty liver disease in adolescents


Wan, F and Pan, F and Ayonrinde, OT and Adams, LA and Mori, TA and Beilin, LJ and O'Sullivan, TA and Olynyk, JK and Oddy, WH, Validation of fatty liver disease scoring systems for ultrasound diagnosed non-alcoholic fatty liver disease in adolescents, Digestive and Liver Disease pp. 1-7. ISSN 1590-8658 (2020) [Refereed Article]

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Copyright 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved

DOI: doi:10.1016/j.dld.2020.11.037


Background and aims: The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing in young populations. However, there are inadequate data regarding diagnosis of NAFLD. We aimed to validate three scoring systems against a previous standard of suprailiac skinfold thickness for diagnosing NAFLD in population-based adolescents.

Methods: Seventeen-year-old adolescents (n = 899), participating in the Raine Study, attended a cross-sectional follow-up. NAFLD was diagnosed using liver ultrasound. Scores for Fatty liver index (FLI), Hepatic Steatosis Index (HSI) and Zhejiang University index (ZJU index) were calculated. Diagnostic accuracy of these diagnostic tests was evaluated through discrimination and calibration.

Results: NAFLD was diagnosed 9% in males and 15% in females. The three scoring systems demonstrated better discrimination performance for NAFLD in males (AUC was FLI:0.82, HSI: 0.83 and ZJU index: 0.83) compared to females (AUC was FLI: 0.67, HSI: 0.67 and ZJU index: 0.67). Suprailiac skinfold performed better than the scoring systems (overall AUC: 0.82; male AUC:0.88; female AUC:0.73). FLI had best calibration performance.

Conclusion: Suprailiac skinfold thickness was a better predictor of ultrasound-diagnosed NAFLD than the three diagnostic scoring systems investigated. The higher performance characteristics of the algorithmic scoring systems in males compared with females may have implications for use in population assessments.

Item Details

Item Type:Refereed Article
Keywords:adolescents, calibration plot, fatty liver/ultrasonography, ROC Curve, The Raine Study
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Gastroenterology and hepatology
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Adolescent health
UTAS Author:Wan, F (Mr Fuzhen Wan)
UTAS Author:Pan, F (Dr Feng Pan)
UTAS Author:Oddy, WH (Professor Wendy Oddy)
ID Code:142194
Year Published:2020
Web of Science® Times Cited:5
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-12-22
Last Modified:2021-03-23

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