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. 2010 Jul;42(7):503-8.
doi: 10.1016/j.dld.2009.08.002. Epub 2009 Sep 18.

Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease

Jeong-Hoon Lee  1 , Donghee Kim, Hwa Jung Kim, Chang-Hoon Lee, Jong In Yang, Won Kim, Yoon Jun Kim, Jung-Hwan Yoon, Sang-Heon Cho, Myung-Whun Sung, Hyo-Suk Lee
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Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease

Jeong-Hoon Lee et al. Dig Liver Dis. 2010 Jul.

Abstract

Background/aims: To optimize management of nonalcoholic fatty liver disease (NAFLD), a simple screening tool is necessary. In this study, we aimed to devise a simple index of NAFLD.

Study: A cross-sectional study with 10,724 health check-up subjects (5362 cases with NAFLD versus age- and sex-matched controls) was conducted. Study subjects were randomly assigned to a derivation cohort or a validation cohort.

Results: Multivariate analysis indicated that high serum alanine aminotransferase (ALT) to serum aspartate aminotransferase (AST) ratio, high body mass index (BMI), and diabetes mellitus were independent risk factors of NAFLD (all P<0.001). Using these variables, a formula was derived by a logistic regression model: hepatic steatosis index (HSI)= 8 x(ALT/AST ratio)+BMI (+2, if female; +2, if diabetes mellitus). HSI had an area under receiver-operating curve of 0.812 (95% confidence interval, 0.801-0.824). At values of <30.0 or >36.0, HSI ruled out NAFLD with a sensitivity of 93.1%, or detected NAFLD with a specificity of 92.4%, respectively. Of 2692 subjects with HSI <30.0 or >36.0 in the derivation cohort, 2305 (85.6%) were correctly classified. HSI was validated in the subsequent validation cohort.

Conclusion: HSI is a simple, efficient screening tool for NAFLD that may be utilized for selecting individuals for liver ultrasonography and for determining the need for lifestyle modifications.

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