Validation of fatty liver index and lipid accumulation product for predicting fatty liver in Korean population

Kim, Jeong H.; Kwon, So Young; Lee, Sang W.; Lee, Chang H.

doi:10.1111/j.1478-3231.2011.02580.x

Cited by 93 publications

(93 citation statements)

References 7 publications

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“…With the same diagnostic criteria for fatty liver disease (by ultrasonography) [6], we also showed a good correlation between FLI and non-alcoholic fatty liver disease (pearson’s correlation r = 0.372, P < 0.001) in a special Chinese population who underwent coronary angiography. The accuracy of FLI was relatively lower (AUC-ROC value = 0.721, 95% CI: 0.678-0.764) than that of Bedogni et al’s study, but was nearly the same as that of Korean general population (accuracy of 0.785, 95% CI: 0.728–0.842) [13]. The results of our study provided further evidences that FLI could be considered as an easy and useful marker for screening fatty liver subjects in both general and special population.…”

Section: Discussionmentioning

confidence: 93%

Fatty liver index correlates with non-alcoholic fatty liver disease, but not with newly diagnosed coronary artery atherosclerotic disease in Chinese patients

Jiang

Chang

et al. 2013

BMC Gastroenterol

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BackgroundFatty liver index (FLI) was recently established to predict non-alcoholic fatty liver disease (NAFLD) in general population, which is known to be associated with coronary artery atherosclerotic disease (CAD).This study aims to investigate whether FLI correlates with NAFLD and with newly diagnosed CAD in a special Chinese population who underwent coronary angiography.MethodsPatients with CAD (n = 231) and without CAD (n = 482) as confirmed by coronary angiography were included. Among them, 574 patients underwent B-ultrosonography were divided into NAFLD group (n = 209) and non-NAFLD group (n = 365). Correlation between FLI and NAFLD was analyzed using pearson’s correlation. The associations between FLI and NAFLD as well as CAD were assessed using logistic regression. The predictive accuracy of FLI for NAFLD was evaluated using receiver operating characteristics (ROC) curve analysis.ResultsFLI was significantly higher in NAFLD group (37.10 ± 1.95) than in non-NAFLD group (17.70 ± 1.04), P < 0.01. FLI correlated with NAFLD (r = 0.372, P < 0.001). The algorithm for FLI had a ROC-AUC of 0.721 (95% CI: 0.678–0.764) in the prediction of NAFLD. Logistic regression analysis showed that FLI was associated with NAFLD (adjusted OR = 1.038, 95% CI: 1.029-1.047, P < 0.01). The proportion of patients with CAD did not differ among the groups of FLI ≤ 30 (32.3%), 30-60 (31.0%), and ≥60 (35.3%). No significant association was found between FLI and CAD (adjusted OR = 0.992, 95% CI: 0.981-1.003 in men and OR = 0.987, 95% CI: 0.963-1.012 in women, P > 0.05).ConclusionsFLI showed good correlation with NAFLD in patients who underwent coronary angiography, but not with newly diagnosed CAD. This might be underestimated because some patients in non-CAD group may have other underlying cardiovascular diseases.

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Section: Discussionmentioning

confidence: 93%

Fatty liver index correlates with non-alcoholic fatty liver disease, but not with newly diagnosed coronary artery atherosclerotic disease in Chinese patients

Jiang

Chang

et al. 2013

BMC Gastroenterol

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“…FLI additionally has advantages in large population studies for providing high accuracy and less error by the examiner. This index showed good predictive value for detection of fatty liver and was validated in studies with the Korean population [33,34]. There are reasons why we used FLI for this study.…”

Section: Discussionmentioning

confidence: 97%

The Role of Skeletal Muscle in Development of Nonalcoholic Fatty Liver Disease

et al. 2013

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BackgroundNonalcoholic fatty liver disease (NAFLD) is closely correlated with abnormal accumulation of visceral fat, but the role of skeletal muscle remains unclear. The aim of this study was to elucidate the role of skeletal muscle in development of NAFLD.MethodsAmong 11,116 subjects (6,242 males), we examined the effects of skeletal muscle mass and visceral fat area (VFA, by bioelectric impedance analysis) on NAFLD using by the fatty liver index (FLI).ResultsOf the total subjects (9,565 total, 5,293 males) included, 1,848 were classified as having NALFD (FLI ≥60). Body mass index, lipid profile, fasting plasma glucose, hemoglobin A1c, prevalence of type 2 diabetes (DM), hypertension (HTN), and metabolic syndrome were higher in males than females, but FLI showed no significant difference. The low FLI group showed the lowest VFA and highest skeletal muscle mass of all the groups. Skeletal muscle to visceral fat ratio (SVR) and skeletal muscle index had inverse correlations with FLI, when adjusted for age and gender. In multivariate regression analysis, SVR was negatively associated with FLI. Among SVR quartiles, the highest quartile showed very low risk of NAFLD when adjusted for age, gender, lipid profile, DM, HTN, and high sensitivity C-reactive protein from the lowest quartiles (odds ratio, 0.037; 95% confidence interval, 0.029 to 0.049).ConclusionSkeletal muscle mass was inversely associated with visceral fat area, and higher skeletal muscle mass may have a beneficial effect in preventing NAFLD. These results suggest that further studies are needed to ameliorate or slow the progression of sarcopenia.

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“…However, FLI is a simple index which only requires measurement of BMI, waist circumference, GGT, and TG. The FLI can detect NAFLD assessed by magnetic resonance spectroscopy with considerable accuracy [14] and has been well validated in a Korean population [15,36]. Therefore, to determine the clinical utility of FLI as a predictor of renal dysfunction, we used statistical methods, including two newly described metrics, IDI and NRI.…”

Section: Discussionmentioning

confidence: 99%

“…Bedogni et al developed a simple scoring system called the fatty liver index (FLI) as a predictor of hepatic steatosis [14], and it has been well validated in Korean populations and other ethnic groups [15,16]. The objective of this study was determining the independent association between hepatic steatosis as measured by FLI and new-onset CKD over a 10-year follow-up period.…”

Section: Introductionmentioning

confidence: 99%

The fatty liver index as a predictor of incident chronic kidney disease in a 10-year prospective cohort study

et al. 2017

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BackgroundAlthough non-alcoholic fatty liver disease (NAFLD) is considered to be associated with chronic kidney disease (CKD), long-term follow up data is lacking. We investigated whether NAFLD, as determined by the fatty liver index (FLI), could predict incident CKD in 10-year prospective cohort study. We also assessed the clinical utility of FLI to predict the development of CKD.Methods6,238 adults aged 40 to 69 years without baseline CKD from the Ansan—Ansung cohort were examined. Patients were classified according to FLI as follows: FLI<30, no NAFLD; FLI≥60, NAFLD; and 30≤ FLI<60, intermediate. Incident CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m2. The clinical utility of FLI in predicting incident CKD was estimated via area under the receiver-operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) analyses.ResultsDuring an average of 10 years of follow-up, 724 subjects (15.21%) developed CKD. The adjusted hazard ratio [95% confidence interval (CI)] for incident CKD increased in a graded manner with FLI increased (<30 vs. 30–59 vs. ≥60 = 1 vs. 1.17 [0.997–1.375] vs. 1.459 [1.189–1.791], respectively, P for trend = 0.0012). Incorporation of FLI into traditional risk factors of CKD significantly increased prediction of incident CKD based on NRI (17%; 95% CI, 8.9–25%; P-value <0.001) and IDI (0.002; 95% CI, 0.0046–0.0143; P-value = 0.046).ConclusionsFLI, a surrogate marker of NAFLD, was an independent risk factor for incident CKD. FLI provides meaningful incremental risk reclassification beyond that of conventional risk factors of CKD.

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Validation of fatty liver index and lipid accumulation product for predicting fatty liver in Korean population

Cited by 93 publications

References 7 publications

Fatty liver index correlates with non-alcoholic fatty liver disease, but not with newly diagnosed coronary artery atherosclerotic disease in Chinese patients

Fatty liver index correlates with non-alcoholic fatty liver disease, but not with newly diagnosed coronary artery atherosclerotic disease in Chinese patients

The Role of Skeletal Muscle in Development of Nonalcoholic Fatty Liver Disease

The fatty liver index as a predictor of incident chronic kidney disease in a 10-year prospective cohort study

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