Fatty Liver Index is a valid predictor of non-alcoholic fatty liver disease (NAFLD) in pregnancy

Koralegedara, Iresha Sandamali; Warnasekara, Janith; Rathnayake, Ashani; Dayaratne, Korale Gedara; Agampodi, Suneth

doi:10.1136/bmjgast-2022-000913

Cited by 6 publications

(6 citation statements)

References 52 publications

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“…Additionally, a mathematical model provides a standardized framework to monitor disease progression and response to treatment over time. By quantifying grayscale levels, it becomes possible to detect subtle variations and track even small changes in NAFLD, allowing for early intervention and management (15). Moreover, a mathematical model enables researchers and clinicians to investigate potential correlations between grayscale levels and various clinical outcomes, facilitating a deeper understanding of the disease and potentially leading to the identi cation of novel prognostic markers or treatment targets.…”

Section: Discussionmentioning

confidence: 99%

Estimating Levels of Echogenicity in Non-Alcoholic Fatty Liver Disease - a Mathematical Model

Andrade

Oliveira

et al. 2023

Preprint

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Introduction Echogenicity is a measure used in ultrasound imaging to assess the ability of tissue to reflect sound waves. In the case of hepatic tissue, it is important to identify and classify different levels of echogenicity to assist in diagnosing possible alterations. As ultrasound imaging is operator-dependent, there is a gap in accurately defining the levels of non-alcoholic fatty liver disease (NAFLD). Objective To develop a mathematical model for estimating levels of echogenicity in hepatic tissue in NAFLD based on grayscale values. Method The common number of grayscale levels in an ultrasound is 256. We utilized a dataset containing experimental grayscale values (Ci) and corresponding echogenicity values (Ei). The method of least squares was applied to determine the equations describing the relationship between Ci and Ei. Results We assume that E is a linear function of the grayscale, given by: E = m * C + b. Where: E = is the unit of measurement of echogenicity, C = is the value of the grayscale (0 to 256), m = is the slope coefficient of the line relating E to C - b is the intercept coefficient of the line. The results derived from the least squares method provided the following regression equations: m = (Σ(Ci - Cm) * (Ei - Em)) / (Σ(Ci - Cm)^2) and b = Em - m * Cm. These equations allowed us to estimate the levels of echogenicity in hepatic tissue based on grayscale values. Thus, on a grayscale ranging from 0 to 256, hepatic tissue with normal echogenicity presented a value within the range of 120 to 150; mild NAFLD had a value between 150 and 180; moderate NAFLD had a value between 180 and 210; severe NAFLD had a value above 210. Conclusion This study developed a mathematical model for estimating levels of echogenicity in hepatic tissue using a grayscale ranging from 0 to 256. The regression equations obtained through the method of least squares can be used to calculate the degrees of NAFLD. This estimation can assist in the diagnosis and monitoring of hepatic tissue alterations during ultrasound examinations.

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Section: Discussionmentioning

confidence: 99%

Estimating Levels of Echogenicity in Non-Alcoholic Fatty Liver Disease - a Mathematical Model

Andrade

Oliveira

et al. 2023

Preprint

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Section: Discussionmentioning

confidence: 99%

“…[12,13] However, challenges remain in determining the ideal method to diagnose NAFLD in the context of pregnancy, given that many tools utilized in non-pregnant individuals have not been validated in pregnancy. [14][15][16] Our study has several unique strengths. First, data were obtained from screening consecutive L&D admissions.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of elevated alanine aminotransferase (ALT) in pregnancy: A cross-sectional labor and delivery-based assessment

et al. 2022

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Since liver tests are not routinely checked in pregnancy, the prevalence of abnormal liver tests and liver-related abnormalities in pregnancy in a US-based population is not known. We sought to determine the prevalence of abnormal alanine aminotransferase (ALT) among pregnant Individuals who present to labor and delivery for evaluation and to evaluate prevalence of underlying diagnosed liver conditions. Prospective study evaluating liver tests in consecutive samples obtained on the labor and delivery unit. Patient characteristics were compared between those with and without abnormal ALT and those with and without abnormal ALT without a liver-related diagnosis made in clinical practice, using t tests for continuous measures and χ2 or Fisher's exact tests as appropriate for categorical measures. Logistic regression was utilized to identify factors associated with abnormal ALT in this subcohort to determine predictors of abnormal ALT in those without a known liver-related diagnosis. We collected 1024 laboratory specimens from 996 patients. Of these patients, 131 of 996 (13.2%) had elevated ALT ≥25 IU/L; 20 (2%) had ALT ≥50, 6 (0.6%) had ALT ≥125 and 3 (0.3%) had ALT ≥250. 61/131 (46.6%) of patients with ALT ≥25 IU/L had not had LTs checked during routine pregnancy care. 20 (15%) of individuals with abnormal LT had preeclampsia; 5 (4%) had cholestasis of pregnancy; 1 (0.8%) had hepatitis C; there were no other chronic liver diseases diagnosed. There were no significant demographic or clinical differences between those with and without ALT ≥25, whether liver disease diagnosis was made or not. We identified an over 10% prevalence of abnormal LTs in consecutive pregnant individuals who presented to L&D, most of whom did not have a liver-related condition diagnosed in clinical practice. Among those with liver-related diagnoses, PE and ICP were the most common among individuals with ALT≥25 IU/mL, with chronic liver disease rarely diagnosed. Further evaluation of the role of ALT testing as part of routine prenatal care is needed, particularly in establishing a baseline prevalence of liver test abnormalities in pregnancy and independent association with pregnancy outcomes.

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“…Fatty liver index (FLI) is a surrogate marker of hepatic steatosis, which is estimated from a formula that includes waist circumference (WC), body mass index (BMI), gamma-glutamyltransferase (GGT), and triglycerides (TG) [ 12 ]. This index could replace ultrasonography to diagnose the extent of hepatic steatosis and is a valid predictor of NAFLD [ 13 ]. Several studies have previously observed that FLI was a predictor of diabetes development [ 5 , 13 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…This index could replace ultrasonography to diagnose the extent of hepatic steatosis and is a valid predictor of NAFLD [ 13 ]. Several studies have previously observed that FLI was a predictor of diabetes development [ 5 , 13 – 16 ]. A meta-analysis [ 16 ] identified a positive association between FLI and the risk of diabetes mellitus incidence.…”

Section: Introductionmentioning

confidence: 99%

The association between fatty liver index and onset of diabetes: secondary analysis of a population-based cohort study

Zhu

et al. 2023

BMC Public Health

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Background According to research, the fatty liver index (FLI) is associated with diabetes. However, few studies have been conducted to investigate the relationship between FLI and diabetes risk from various perspectives. This study comprehensively investigated the relationship between FLI and incident diabetes in a large Japanese population. Methods This retrospective cohort study included 14,280 participants from Murakami Memorial Hospital in Japan from 2004 to 2015. The independent and dependent variables are FLI and risk of type 2 diabetes mellitus (T2DM), respectively. To examine the link between FLI and incident T2DM, Cox proportional-hazards regression was employed. In addition, we performed a number of sensitivity studies to guarantee the validity of the results. Moreover, we conducted subgroup analyses. Results After adjusting covariates, the results showed that FLI was positively associated with the risk of T2DM (HR = 1.019, 95%CI: 1.012, 1.025). Additionally, the sensitivity analysis showed how reliable the outcomes were. And a stronger association between FLI and incident T2DM was observed in the regular exercisers (HR = 1.036, 95%CI: 1.019–1.053, P < 0.0001) and the population without ethanol consumption (HR = 1.028, 95%CI: 1.017–1.039, P < 0.0001). Besides, receiver operating characteristic (ROC) curve analysis showed that FLI was better than waist circumference, triglycerides, body mass index, and gamma-glutamyl transferase in predicting incident T2DM. Conclusion FLI is positively associated with incident T2DM.

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Fatty Liver Index is a valid predictor of non-alcoholic fatty liver disease (NAFLD) in pregnancy

Cited by 6 publications

References 52 publications

Estimating Levels of Echogenicity in Non-Alcoholic Fatty Liver Disease - a Mathematical Model

Estimating Levels of Echogenicity in Non-Alcoholic Fatty Liver Disease - a Mathematical Model

Prevalence of elevated alanine aminotransferase (ALT) in pregnancy: A cross-sectional labor and delivery-based assessment

The association between fatty liver index and onset of diabetes: secondary analysis of a population-based cohort study

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