Validation of fatty liver index as a marker for metabolic dysfunction-associated fatty liver disease

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new nomenclature for nonalcoholic fatty liver. Along with obesity, fatty liver associated with metabolic dysfunction is increasing and has become a serious socioeconomic problem. Non-invasive testing for the confirmation of MAFLD, including the fatty liver index (FLI), can be used as an alternative method for diagnosing steatosis when imaging modalities are not available. To date, few studies have examined the effectiveness and validity of FLI for diagnosing MAFLD. Therefore, this study analyzed the effectiveness and validity of FLI for diagnosing MAFLD.

Medical records of men and women aged ≥ 19 years who underwent abdominal computed tomography (CT) examination at our facility between March 2012 and October 2019 were retrospectively reviewed. A comparative analysis between non-continuous variables was performed using the chi-squared test. The area under receiver operating characteristic (AUROC) curve was used to verify the effectiveness of FLI as a predictive index for MAFLD.

Analysis of the association between MAFLD and abdominal CT revealed that the sensitivity and specificity of FLI for diagnosing MAFLD were 0.712 and 0.713, respectively. The AUROC of FLI for predicting MAFLD was 0.776.

Our study verified the accuracy of FLI for predicting MAFLD using CT. The FLI can be used as a simple and cost-effective tool for screening MAFLD in clinical settings.