Comparisons between different scoring systems in the detection and grading of nonalcoholic fatty liver disease

Background Nonalcoholic fatty liver disease (NAFLD) is considered a main cause of liver disease globally, with increasing incidence and prevalence because of the global obesity pandemic. NAFLD typically worsens with time and is associated with significant morbidity and mortality. Aim This study aimed to determine the role of noninvasive scoring systems [Hepatic steatosis index (HSI), Fatty liver index (FLI), and Lipid accumulation product (LAP)] in the diagnosis and grading of NAFLD. Patients and methods This study was conducted on 60 patients classified into three groups according to ultrasound grading of NAFLD (mild, moderate, and severe groups), besides 20 healthy patients as a control group. All participants were subjected to laboratory tests [liver function tests (alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase, serum albumin, serum bilirubin), fasting and postprandial blood glucose levels, and lipid profile (serum triglycerides, serum cholesterol (S Ch), high-density lipoprotein (HDL), and low-density lipoprotein (LDL)], anthropometric measures [height, weight, body mass index (BMI), and waist circumference (WC)], and diagnostic abdominal ultrasonography to assess NAFLD and severity. HSI, FLI, and LAP were calculated. Results The three indices were positively correlated with systolic blood pressure, diastolic blood pressure, BMI, WC, gamma-glutamyl transferase, AST, ALT, fasting blood glucose, postprandial blood glucose, triglyceride, S Ch, HDL, and LDL. The three indices showed good overall performance in diagnosis and differentiating NAFLD grades, but HSI was the best among them, as it had the largest area under the curve and the highest sensitivity and specificity, followed by FLI. LAP had the least diagnostic performance. Conclusions In addition to differentiating between healthy individuals and NAFLD patients, HSI may be a reliable and accurate noninvasive technique for assessing various NAFLD grades.