The Fatty Liver Index has limited utility for the detection and quantification of hepatic steatosis in obese patients

IntroductionWomen with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances and might be affected by hepatic steatosis. The fatty liver index (FLI) was developed as a simple and accurate predictor of hepatic steatosis. We aimed to analyze the association of FLI with endocrine and metabolic parameters in a cohort of PCOS and control women.MethodsFLI was calculated using body mass index (BMI), waist circumference, triglycerides, and gamma-glutamyl transferase in 611 PCOS and 139 BMI-matched control women within the same age range. Elevated FLI was defined as >60. Metabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed.ResultsPCOS women had significantly higher FLI levels than control women in age-adjusted analyses (11.4 (4.3–48.8) and 8.8 (3.9–35.0), respectively,P=0.001), whereas fibrosis indices were similar (aspartate amino transferase-to-platelet ratio index) or lower (FIB-4) respectively. In binary logistic regression analysis adjusted for age, odds ratio (OR) for elevated FLI was 2.52 (1.31–4.85),P=0.006, for PCOS women when compared with controls. PCOS women with high FLI levels had an adverse anthropometric, metabolic, and endocrine risk profile. The prevalence of elevated FLI was 88.7% in PCOS women with metabolic syndrome (MS) and 11.3% in PCOS women without MS (P<0.001). In control women, elevated FLI was present in 66.7% of women with MS and 30.8% of women without MS.ConclusionHigh FLI levels are a common finding in obese PCOS women and are closely linked to MS. FLI calculation might be a useful tool for identifying PCOS patients at high risk for metabolic and hepatic disturbances.

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383 A COMPARISON OF FATTY LIVER INDEX WITH THREE NON-INVASIVE METHODS FOR THE DETECTION AND QUANTIFICATION OF LIVER STEATOSIS: REGULAR ULTRASOUND, HEPATORENAL ULTRASOUND INDEX AND STEATOTEST

Journal of Hepatology ◽

10.1016/s0168-8278(10)60385-6 ◽

2010 ◽

Vol 52 ◽

pp. S158

Author(s):

S. Zelber-Sagi ◽

M. Webb ◽

M. Leshno ◽

L. Blendis ◽

H. Yeshua ◽

...

Keyword(s):

Fatty Liver ◽

Liver Steatosis ◽

Non Invasive ◽

Liver Index ◽

Fatty Liver Index ◽

Detection And Quantification

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Comparison of fatty liver index with noninvasive methods for steatosis detection and quantification

World Journal of Gastroenterology ◽

10.3748/wjg.v19.i1.57 ◽

2013 ◽

Vol 19 (1) ◽

pp. 57 ◽

Cited By ~ 58

Author(s):

Shira Zelber-Sagi

Keyword(s):

Fatty Liver ◽

Noninvasive Methods ◽

Liver Index ◽

Fatty Liver Index ◽

Detection And Quantification

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Utility of Fatty Liver Index to predict reversion to normoglycemia in people with prediabetes

PLoS ONE ◽

10.1371/journal.pone.0249221 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249221

Author(s):

Carla Busquets-Cortés ◽

Miquel Bennasar-Veny ◽

Ángel Arturo López-González ◽

Sergio Fresneda ◽

Manuela Abbate ◽

...

Keyword(s):

Physical Activity ◽

Fatty Liver ◽

Hepatic Steatosis ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Dietary Habits ◽

Incident Type ◽

Liver Index ◽

Fatty Liver Index ◽

Fasting Plasma

Background Fatty Liver Index (FLI) is strongly associated with changes in glycemic status and incident Type 2 Diabetes (T2D). The probability of reverting to normoglycemia from a state prediabetes could be determined by FLI, however such relationship remains poorly understood. Aim To determine the clinical interest of using FLI to estimate prediabetes reversion at 5 years in patients with impaired fasting plasma glucose at baseline, and identify those factors associated with changes in FLI, that could contribute to the reversion of prediabetes. Methods This 5-year cohort study included 16,648 Spanish working adults with prediabetes. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dl according to the ADA criteria, while prediabetes reversion was defined as a FPG <100 mg/dL. The population was classified as: FLI <30 (no hepatic steatosis), FLI 30–59 (intermediate status), and FLI ≥60 (hepatic steatosis). Results At 5 years follow-up, 33.7% of subjects reverted to normoglycemia (annual rate of 6.7%). The adjusted binomial logistic regression model showed that scoring FLI <30 (OR 1.544; 95% CI 1.355–1.759), performing at least 150 min/week of physical activity (OR 4.600; 95% CI 4.088–5.177) and consuming fruits and vegetables daily (OR 1.682; 95% CI 1.526–1.855) were associated with the probability of reverting form prediabetes to normoglycemia. The ROC curve for prediction of reversion showed that FLI (AUC 0.774;95% CI 0.767–0.781) was a better predictor than FPG (AUC 0.656; 95% CI 0.648–0.664). Conclusions Regular physical activity, healthy dietary habits and absence of hepatic steatosis are independently associated with the probability of reversion to normoglycemia in adult workers with prediabetes at baseline. Low FLI values (especially FLI< 30) may be useful to predict the probability of prediabetes reversion, especially in active subjects with healthy eating habits, and thus identify those who might benefit from early lifestyle intervention.

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Fatty liver index and progression to type 2 diabetes: a 5-year longitudinal study in Spanish workers with pre-diabetes

BMJ Open ◽

10.1136/bmjopen-2020-045498 ◽

2021 ◽

Vol 11 (8) ◽

pp. e045498

Author(s):

Carla Busquets-Cortés ◽

Miquel Bennasar-Veny ◽

Angel-Arturo López-González ◽

Sergio Fresneda ◽

Antoni Aguiló ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Fatty Liver ◽

Hepatic Steatosis ◽

Occupational Health Services ◽

Alcoholic Fatty Liver ◽

Liver Index ◽

Fatty Liver Index

ObjectiveThe main aim of the study was to evaluate the association between non-alcoholic fatty liver disease (NAFLD), estimated by fatty liver index (FLI), and the development of type 2 diabetes (T2D) in a large cohort of adult workers with pre-diabetes.DesignProspective cohort study.SettingOccupational health services from Spain.Participants16 648 adult workers (aged 20–65 years) with pre-diabetes (fasting plasma glucose (FPG) of 100–125 mg/dL).Outcome and measuresFLI was calculated based on measurements of triglycerides, body mass index, waist circumference and γ-glutamyltransferase. The population was classified into three categories: FLI<30 (no hepatic steatosis), FLI 30–60 (intermediate status) and FLI>60 (hepatic steatosis). Sociodemographic, anthropometric, dietary habits, physical activity and clinical data were collected from all subjects. The incidence rate of T2D was determined after 5 years of follow-up.ResultsAfter 5 years of follow-up, 3706 of the 16 648 participants (22.2%) were diagnosed with T2D, corresponding to an annual rate of progression of 4.5%. FLI was strongly associated with T2D conversion. The incidence rates of T2D in the FLI<30, FLI 30–60 and FLI>60 groups were significantly different after 5 years of follow-up were 19/6,421 (0.3%), 338/4,318 (7.8%) and 3,349/5,909 (56.7%), respectively. This association remained significant for FLI>60 after adjustment for, age, diet, physical activity, FPG, blood pressure, social class and smoking habits (adjusted HR=6.879; 95% CI 5.873 to 8.057 for men, and HR=5.806; 95% CI 4.863 to 6.932 for women).ConclusionNAFLD assessed by FLI independently predicted the risk of conversion to T2D among people with pre-diabetes. FLI may be an easily determined and valuable early predictor for T2D in people with pre-diabetes. FLI-based assessment of NAFLD in subjects with pre-diabetes in routine clinical practice could allow the adoption of effective measures to prevent and reduce their progression to T2D.

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Comparison of the ability between fatty liver index and triglyceride glucose index to screen hepatic steatosis in postmenopausal women: a cross-sectional study

10.21203/rs.3.rs-20743/v1 ◽

2020 ◽

Author(s):

Peng Ju Liu ◽

Fang Ma ◽

Yan Ning Zhu ◽

Hui Ping Lou

Keyword(s):

Fatty Liver ◽

Postmenopausal Women ◽

Hepatic Steatosis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Liver Index ◽

Fatty Liver Index ◽

Triglyceride Glucose Index ◽

Obesity Indices

Abstract Background: To compare the potential of triglyceride glucose index (TyG) and fatty liver index (FLI) and to explore which index is better for detecting nonalcoholic fatty liver disease (NAFLD).Methods: A cross-sectional study was conducted in 594 Chinese nondiabetic postmenopausal women retrospectively. NAFLD was defined as a hepatic steatosis observed on liver ultrasonography in the absence of a second cause. Binary Logistic regression model analysis was used to determine odds ratio (OR) and corresponding 95% confidence interval (CI) between hepatic steatosis and TyG as well as FLI. Receiver operating characteristic curve (ROC) and area under curve (AUC) were employed to determine the ability of FLI and TyG as well as the combination of TyG with obesity indices to detect hepatic steatosis, and the AUC values were also compared between them. Results: women with the highest value of FLI or TyG had significantly higher odds of hepatic steatosis. The AUC values of FLI was significantly larger than that of TyG in either overall women (difference between area: 0.0743, 95% CI: 0.0396-0.109, P < 0.0001) or women younger (difference between area: 0.0629, 95% CI: 0.0262-0.0996, P=0.0008) and older (difference between area: 0.116, 95% CI: 0.0242-0.207, P=0.0132) than 60 years. Furthermore, when TyG was added to each obesity index, the AUC value of FLI was still significantly larger than that of each combination. Conclusions: Compared with TyG along or combination of TyG and obesity indices, FLI is a better surrogate index for detecting hepatic steatosis among Chinese nondiabtic postmenopausal women.

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676 The fatty liver index: A simple and accurate predictor of hepatic steatosis

Journal of Hepatology ◽

10.1016/s0168-8278(06)80676-8 ◽

2006 ◽

Vol 44 ◽

pp. S249-S250

Author(s):

A. Castiglione ◽

G. Bedogni ◽

L. Miglioli ◽

L.S. Crocè ◽

E. Masutti ◽

...

Keyword(s):

Fatty Liver ◽

Hepatic Steatosis ◽

Accurate Predictor ◽

Liver Index ◽

Fatty Liver Index

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Association of Hepatic Steatosis Index and Fatty Liver Index with Carotid Atherosclerosis in Type 2 Diabetes

International Journal of Medical Sciences ◽

10.7150/ijms.62010 ◽

2021 ◽

Vol 18 (14) ◽

pp. 3280-3289

Author(s):

Chenxi Wang ◽

Zhensheng Cai ◽

Xia Deng ◽

Haoxiang Li ◽

Zhicong Zhao ◽

...

Keyword(s):

Type 2 Diabetes ◽

Fatty Liver ◽

Hepatic Steatosis ◽

Carotid Atherosclerosis ◽

Liver Index ◽

Fatty Liver Index ◽

Hepatic Steatosis Index

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Combined Effects of Lifestyle Risk Factors on Fatty Liver Index

10.21203/rs.2.23063/v1 ◽

2020 ◽

Author(s):

Ulla Nivukoski ◽

Markus Niemelä ◽

Aini Bloigu ◽

Risto Bloigu ◽

Mauri Aalto ◽

...

Keyword(s):

Risk Factors ◽

Fatty Liver ◽

Hepatic Steatosis ◽

Linear Trend ◽

Total Risk ◽

Cross Sectional ◽

Lifestyle Risk Factors ◽

Liver Index ◽

Fatty Liver Index ◽

Lifestyle Risk

Abstract Background: Factors of lifestyle may have a major impact on liver-related morbidity and mortality.We examined independent and joint effects of lifestyle risk factors on fatty liver index (FLI), a biomarker of hepatic steatosis, in a population-based cross-sectional national health survey. Methods: The study included 12,368 participants (5,784 men, 6,584 women) aged 25–74 years. Quantitative estimates of alcohol use, smoking, adiposity and physical activity were used to establish a total score of risk factors, with higher scores indicating an unhealthier lifestyle. FLI was calculated based on an algorithm including body mass index, waist circumference, serum gamma-glutamyltransferase and triglycerides.Results: The occurrence of FLI ≥ 60% indicating fatty liver increased from 2.4% in men with zero risk factors to 81.9% in those with a total risk score of 7–8 (p < 0.0005 for linear trend) and in women from 0% to 73.5% (p < 0.0005). The most striking individual impacts on the likelihood for FLI above 60% were observed for physical inactivity (p < 0.0005 for both genders) and alcohol consumption (p < 0.0005 for men). Interestingly, coffee consumption was also found to increase with increasing risk factor scores (p < 0.0005 for linear trend in both genders).Conclusions: The data indicates that unfavorable combinations of lifestyle risk factors lead to a high likelihood of hepatic steatosis. Use of FLI as a diagnostic tool may benefit the assessment of interventions aimed at maintaining a healthy lifestyle and prevention of liver-related morbidity.

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