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The NAFLD fibrosis score has high negative predictive value in excluding advanced fibrosis in the Chinese population, and can reduce the burden of liver biopsy in the vast majority of cases. Since there were few cases of advanced fibrosis in this cohort, this study had limited power in validating the high cutoff point.

Background and Aim: Hypoadiponectinemia and high tumor necrosis factor-alpha (TNF-a) levels are associated with the development of nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the genetic polymorphisms of adiponectin and TNF-a in Chinese NAFLD patients and their association with disease severity. Methods: Seventy-nine patients with histology-proven NAFLD (61 with simple steatosis and 18 with stage 2-4 fibrosis) and 40 controls were tested for the nucleotide polymorphisms at adiponectin -11 391, -11 377, +45, and +276 and TNF-a promoters -863, -308, and -238. Results: There was no significant deviation in the adiponectin and TNF-a gene polymorphisms between NAFLD patients and controls, or between patients with simple steatosis and those with stage 2-4 fibrosis. NAFLD patients with -11377G and +45G at the adiponectin gene were more likely to have hypertriglyceridemia. On multivariate analysis, older age, higher body mass index, and higher fasting glucose were independent factors associated with stage 2-4 fibrosis in NAFLD patients. Conclusions: Adiponectin and TNF-a gene polymorphisms were not shown to be associated with NAFLD or significant fibrosis in Chinese people. The adiponectin -11377G and +45G alleles were associated with hypertriglyceridemia in NAFLD patients. Since the current study is not adequately powered to detect smaller differences in allele frequencies, larger-sized studies in different ethnic groups are required.