Fatty liver index and hepatic steatosis index for prediction of non-alcoholic fatty liver disease in type 1 diabetes

J Gastroenterol Hepatol. 2018 Jan;33(1):270-276. doi: 10.1111/jgh.13814.

Abstract

Background and aim: Little is known about the diagnostic value of hepatic steatosis index (HSI) and fatty liver index (FLI), as well as their link to metabolic syndrome in type 1 diabetes mellitus. We have screened the effectiveness of FLI and HSI in an observational pilot study of 40 patients with type 1 diabetes.

Methods: FLI and HSI were calculated for 201 patients with type 1 diabetes. Forty patients with FLI/HSI values corresponding to different risk of liver steatosis were invited for liver magnetic resonance study. In-phase/opposed-phase technique of magnetic resonance was used. Accuracy of indices was assessed from the area under the receiver operating characteristic curve.

Results: Twelve (30.0%) patients had liver steatosis. For FLI, sensitivity was 90%; specificity, 74%; positive likelihood ratio, 3.46; negative likelihood ratio, 0.14; positive predictive value, 0.64; and negative predictive value, 0.93. For HSI, sensitivity was 86%; specificity, 66%; positive likelihood ratio, 1.95; negative likelihood ratio, 0.21; positive predictive value, 0.50; and negative predictive value, 0.92. Area under the receiver operating characteristic curve for FLI was 0.86 (95% confidence interval [0.72; 0.99]); for HSI 0.75 [0.58; 0.91]. Liver fat correlated with liver enzymes, waist circumference, triglycerides, and C-reactive protein. FLI correlated with C-reactive protein, liver enzymes, and blood pressure. HSI correlated with waist circumference and C-reactive protein. FLI ≥ 60 and HSI ≥ 36 were significantly associated with metabolic syndrome and nephropathy.

Conclusions: The tested indices, especially FLI, can serve as surrogate markers for liver fat content and metabolic syndrome in type 1 diabetes.

Keywords: fatty liver index; hepatic steatosis index; metabolic syndrome; non-alcoholic fatty liver disease; type 1 diabetes mellitus.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Biomarkers
  • Blood Preservation
  • C-Reactive Protein
  • Diabetes Mellitus, Type 1 / complications*
  • Fatty Liver*
  • Female
  • Humans
  • Liver / diagnostic imaging
  • Liver / enzymology
  • Liver / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / diagnosis*
  • Non-alcoholic Fatty Liver Disease / etiology*
  • Pilot Projects
  • Predictive Value of Tests
  • ROC Curve
  • Risk
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Triglycerides
  • Waist Circumference

Substances

  • Biomarkers
  • Triglycerides
  • C-Reactive Protein