Endocrine Abstracts

Background: Nonalcoholic fatty liver disease (NAFLD) is an increasingly recognised disorder with an estimated prevalence of 20–30% in the general population and is considered as the hepatic manifestation of the metabolic syndrome. Fatty liver index (FLI) has been developed as an indicator of hepatic steatosis (HS). Another marker, the lipid accumulation product (LAP) index, initially developed to assess cardiovascular risk, has been recently shown to be a reliable marker of HS.

Objective: To evaluate the use of FLI and LAP markers for the identification of HS in premenopausal women with NAFLD.

Patients and methods: Forty apparently healthy overweight and obese (BMI: 26.0–46.9 kg/m²) premenopausal women (age: 18–45 years) with a history of none or minimal alcohol consumption, were evaluated prospectively for the presence of NAFLD with abdominal ultrasonography and biochemical testing, after excluding causes of secondary liver disease. FLI was calculated using body mass index, waist circumference, serum triglycerides and gamma-glutamyl transferase levels and log-transformed LAP (lnLAP) was calculated using waist circumference and serum triglycerides levels. The diagnostic performance of FLI and lnLAP were assessed with receiver operating characteristic analysis.

Results: HS was detected in 22/40 women (55%) by ultrasonography. Metabolic syndrome was diagnosed in 9/22 HS(+) women (40.9%) and in 1/18 (5.6%) HS(−) women, P=0.01. FLI and lnLAP were higher in HS(+) compared to HS(−) women (71.7±28.5 vs 47.3±24.5 (P<0.01) and 4.0±0.8 vs 3.5±0.4 (P<0.01) respectively). The best cut off for FLI to detect HS was ≥ 47 (sensitivity 77%, specificity 67%) and for lnLAP was >3.5 (sensitivity 82%, specificity 67%).

Conclusion: Calculation of FLI and lnLAP are useful for detecting patients at high risk for NAFLD. In our cohort of premenopausal women with NAFLD a cut-off level ≥ 47 for FLI and ≥3.5 for lnLAP were more discriminative for HS.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.