Accuracy of non-invasive indices for diagnosing hepatic steatosis compared to controlled attenuated parameter (CAP)...

Non-invasive liver indices are valuable tools for identifying patients with Metabolic dysfunction-associated steatotic liver disease, given their simplicity and relatively low cost. This study examined the accuracy of several published indices, the hepatic steatosis index (HSI), Framingham steatosis index (FSI), and Dallas steatosis index (DSI), in predicting steatosis compared to the Transient elastography controlled attenuation parameter (CAP).

This is a retrospective cross-sectional study on 720 patients who underwent a FibroScan at the American University of Beirut Medical Center, between 2015 and 2020. The following indices, HSI, FSI, and DSI were calculated. The sensitivity, specificity, and C-statistics of each index were determined and compared to CAP.

Out of 557patients who met inclusion criteria, 67 % were found to have hepatic steatosis with an average CAP 289.5 (±70.9). The mean age was 50 (±15.6), and 70 % were male. Those patients were found to have higher BMI and higher prevalence of diabetes and HTN as well as dyslipidemia than the control group with no steatosis. The FSI outperformed the other two indices with fair accuracy in detecting hepatic steatosis based on the C-statistics. HSI and DSI, on the other hand, showed poor discriminatory ability. At the cut-off, where specificity was 90 %, the FSI had the highest sensitivity, 49.6 %, compared to the DSI, 28.6 %, and HSI, 21.8 %.

Our study demonstrated the non-invasive index FSI's accuracy in diagnosing steatosis compared to the transient elastography-CAP and highlighted its superiority to other indices, the HSI and DSI.