The diagnostic value of biomarkers (SteatoTest) for the prediction of liver steatosis

310 patients were included in the training group; 434 in three validation groups; and 140 in a control group. SteatoTest was constructed using a combination of the 6 components of FibroTest-ActiTest plus body mass index, serum cholesterol, triglycerides, and glucose adjusted for age and gender. SteatoTest area under the ROC curves was 0.79 (SE = 0.03) in the training group; 0.80 (0.04) in validation group 1; 0.86 (0.03) in validation group 2; and 0.72 (0.05) in the validation group 3 – all significantly higher than the standard markers: γ-glutamyl-transpeptidase or alanine aminotransferase. The median SteatoTest value was 0.13 in fasting controls; 0.16 in non-fasting controls; 0.31 in patients without steatosis; 0.39 in grade 1 steatosis (0–5%); 0.58 in grade 2 (6–32%); and 0.74 in grade 3–4 (33–100%). For the diagnosis of grade 2–4 steatosis, the sensitivity of SteatoTest at the 0.30 cut-off was 0.91, 0.98, 1.00 and 0.85 and the specificity at the 0.70 cut-off was 0.89, 0.83, 0.92, 1.00, for the training and three validation groups, respectively.SteatoTest is a simple and non-invasive quantitative estimate of liver steatosis and may reduce the need for liver biopsy, particularly in patients with metabolic risk factor.Fatty liver or hepatic steatosis is defined as an excessive accumulation of fat in hepatocytes [1]. On worldwide grounds, the prevalence of steatosis is very high, and is associated with several factors such as alcohol, diabetes, overweight, hyperlipidemia, insulin resistance, hepatitis C genotype 3, abetalipoproteinemia and administration of some drugs [1-4].Fatty liver disease involves the accumulation of triglycerides in hepatocytes, apoptosis, hepatocellular ballooning, Mallory's hyaline, necrosis of hepatocytes, lobular inflammation [5,6], small hepatic vein obliteration [7] and often fibrosis with possible progression to cirrhosis, hepatocellular cancer and liver-related death [1,4,8,9].Non-alcoholic fatty liver disease (NAFLD) is an adaptive res