The HAALT Non-invasive Scoring System for NAFLD in Obesity

Area of Science:

• Hepatology
• Metabolic Disorders
• Diagnostic Medicine

Background:

• Non-alcoholic fatty liver disease (NAFLD) prevalence rises with obesity and diabetes.
• Liver biopsy, the current diagnostic standard for NAFLD and NASH, is invasive, costly, and labor-intensive.
• A non-invasive diagnostic method is needed for identifying non-alcoholic steatohepatitis (NASH) in obese Indian populations.

Purpose of the Study:

• To develop and validate a non-invasive scoring system for predicting NASH risk.
• Utilize readily available clinical and biochemical parameters for risk assessment.
• Improve diagnostic accessibility for NASH in obese individuals.

Main Methods:

• A cohort of 290 obese patients undergoing bariatric/metabolic surgery provided pre-operative clinical and biochemical data.
• Data were compared with intra-operative liver biopsy results (NAFLD Activity Score).
• Binary logistic regression identified significant predictors for NASH, forming the basis of the scoring system.

Main Results:

• The study included patients with a mean BMI of 45.5 ± 7.8; 31.7% were diagnosed with NASH.
• Five independent predictors (HbA1c, AST, ALT, liver span on USG, serum triglycerides) were identified.
• The developed scoring system (0-6) showed 85.87% sensitivity and 75.35% accuracy, with scores ≥ 3 indicating high NASH risk.

Conclusions:

• The study validates the association between obesity and NAFLD.
• A simple, non-invasive scoring system effectively identifies obese individuals at high risk for NASH.
• This tool can aid in early detection and management of NASH.