Diagnostic accuracy and clinical utility of a new noninvasive index for hepatic steatosis in patients with hepatitis B virus infection

Abstract

The aim of the present study was to construct a cost-effective noninvasive diagnostic index for prediction of hepatic steatosis in patients with hepatitis B virus(HBV) infection. From January 2011 to January 2015, a total of 364 consecutive subjects who underwent liver biopsies were enrolled. The Receiver-operating characteristic(ROC) curves and Obuchowski measure were constructed to evaluate the diagnostic accuracy of the new index. The AUROCs of steatosis index of patients with HBV infection (SIHBV) in predicting of steatosis were 0.929 (95% confidence interval:0.889–0.970, P < 0.05) in the model group and 0.855 (0.794–0.917, P < 0.05) in the validation group respectively. Comparisons of AUROCs demonstrated that SIHBV was significantly superior to Korean Score, fatty liver index (FLI), hepatic steatosis index (HSI), lipid accumulation product(LAP), and fatty liver disease (FLD) index for prediction of hepatic steatosis in model group and validation group(all P < 0.01). Especially for patients with hepatic steatosis percentage of 5.0–9.9% and 10.0–19.9%, SIHBV had a sensitivity of 63.6% and 79.2%, whereas it were 29.1% and 45.8% for Ultrasonography (all P < 0.05). In conclusion, as a cost-effective, simple, noninvasive, and readily available method, SIHBV may act as a massive screening tool before further examinations such as MRI, CT, transient elastography, or liver biopsy, especially for developing countries.

Lipid accumulation product is a powerful tool to predict non-alcoholic fatty liver disease in Chinese adults

“…Accordingly, it is plausible that the LAP, which is a combination of WC and fasting TG, is significantly associated with NAFLD. However, few studies have so far investigated the association between LAP and NAFLD, and the existing studies have been conducted primarily in subjects with chronic diseases, such as HIV infection [ 45 ], hepatitis B virus infection [ 46 ], and polycystic ovary syndrome [ 47 ], with inconsistent results. Whether LAP is an effective maker for NAFLD that could be widely applied in general Chinese population remains unknown.…”

Association between Non-Alcoholic Fatty Liver Disease and Dietary Habits, Stress, and Health-Related Quality of Life in Korean Adults

“…The hepatic steatosis index (HSI), which is based on levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and body-mass index (BMI), is a useful index to diagnose NAFLD that has been validated in various studies [ 35 , 36 , 37 , 38 , 39 , 40 ]. HSI was reported to have an area under the receiver operating characteristic (AUROC) of 0.81 for the diagnosis of NAFLD [ 35 ], which, although a slightly lower AUROC than that of the Framingham Steatosis Index, was of diagnostic value [ 36 ].…”

“…Another study reported an AUROC of 0.83 for HSI and the tool was deemed to be convenient [ 37 ]. Moreover, HSI is cost effective and can be performed before computed tomography (CT) and magnetic resonance imaging (MRI) based diagnoses [ 38 ]. In a large-scale cohort study, HSI was found to be an effective indicator for predicting NAFLD in comparison to results using ultrasound [ 39 ].…”

Development and Validation of a Simple Index Based on Non-Enhanced CT and Clinical Factors for Prediction of Non-Alcoholic Fatty Liver Disease

“…Some of these models, however, included parameters not always routinely measured in clinical practice. For example, models have included serum concentrations of insulin (24), uric acid (25), hemoglobin A1C (19), and haptoglobin (26), as well as waist circumference (15,27), which are parameters that may not be easily retrieved from patient databases. This may limit the use of these models in retrospective analyses.…”