<p>The fatty liver index, a simple and useful predictor of metabolic syndrome: analysis of the Korea National Health and Nutrition Examination Survey 2010&ndash;2011</p>

Abstract

PurposeNonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, and it is the hepatic manifestation of metabolic syndrome (MetS). We aimed to estimate the prevalence of NAFLD defined by the fatty liver index (FLI), in order to investigate the association between FLI and metabolic disorders and to determine the cutoff value of FLI to screen for MetS.Subjects and methodsThis study utilized a national representative sample of Korean adults (the Korean National Health and Nutrition Examination Surveys) which was conducted in 2010–2011. A total of 10,107 adults aged 19 years or older were selected. NAFLD was diagnosed on the basis of an increased FLI (≥60) after the exclusion of alcohol or viral liver disease.ResultsNAFLD was identified in 1,134 subjects (age-standardized prevalence, 10.0%). When subjects were categorized into three groups by FLI (<20, 20–59, and ≥60), the higher FLI group showed a higher prevalence of hypertension (49.7% vs 14.4%), diabetes mellitus (DM; 20.4% vs 3.8%), and MetS (74.9% vs 7.4%). FLI was positively associated with age, body mass index, blood pressure, hemoglobin A1c, and homeostasis model assessment of insulin resistance (P for trend <0.001). In the multivariate analysis, the higher FLI group had a significantly higher risk for hypertension (OR =2.92, 95% CI =2.18–3.90, P<0.001), DM (OR =4.38, 95% CI =2.96–6.49, P<0.001), and MetS (OR =24.85, 95% CI =17.33–35.64, P<0.001). However, no increase was observed for cardiovascular disease after adjustment of other risk factors. The cutoff value of the FLI estimated to predict the presence of MetS was 20 (area under the curve 0.849, sensitivity 0.828, and negative predictive value 91.9%).ConclusionNAFLD prevalence using FLI is significantly higher in subjects with metabolic disorder including MetS. FLI might be a useful screening tool to detect subjects who may require early management of MetS and who have a high cardiovascular risk.

Fatty liver index and development of cardiovascular disease in Koreans without pre-existing myocardial infarction and ischemic stroke: a large population-based study

“…Another limitation of our study was the use of the FLI as a surrogate measure of NAFLD instead of histological assessment of NAFLD. Furthermore, because FLI comprises known CV risk factors (BMI, triglyceride levels, waist circumference) [28,32], these variables account for the associations observed in the current study. However, to overcome this limitation, we conducted analyses stratified by the presence or absence of these CV risk factors.…”

“…Previously, NAFLD was regarded as a hepatic manifestation of metabolic syndrome, which is a traditional CVD risk factor [28,29]. The specific contribution of NAFLD to increased CVD risk, especially in clinical studies, is difficult to assess separately from the combination of risk factors that are shared by NAFLD and CVD [30].…”

3D Optical Imaging as a New Tool for the Objective Evaluation of Body Shape Changes After Bariatric Surgery

“…This is particularly important as waist circumference is used in many scientific publications and scientifically applied scores [19,20]. The FLI score, for example, is widely used as a predictor for NAFLD and metabolic syndrome [21,22] and for evaluating the effect of different treatment methods [23]. However, the FLI is still under investigation, and researchers continue to adjust how it is calculated to further improve the reliability [24].…”

Overview of the Pathogenesis, Genetic, and Non-Invasive Clinical, Biochemical, and Scoring Methods in the Assessment of NAFLD

“…A widely used algorithm for the diagnosis of simple steatosis is the fatty liver index (FLI), which includes the body mass index (BMI), waist circumference (WC), and serum values of GGT and triglycerides. It has an AUROC of 0.834 for NAFLD [108,109,110]. Borman et al described its limited use in obese patients with an AUROC of 0.67 [111].…”