How can we predict steatosis using biochemical markers (SteatoTest and Fatty liver index)?

Objective: The aim of this study was to establish the diagnostic performance of two biologicalmarkers - fatty liver index (FLI) and SteatoTest, in identifying hepatic steatosis and assessing its degree.Material and Methods: Seventy seven patients with biopsy-proven non-alcoholic fatty liver disease(NAFLD) were prospectively studied and compared with 18 healthy subjects. The patients were stratifiedaccording to the degree of hepatic steatosis. Two biochemical markers, FLI and SteatoTest, weredetermined. The diagnostic value of each method was assessed using sensitivity (Se), specificity (Sp),positive predictive value (PPV), negative predictive value (NPV) and the area under the receivingoperating characteristics curve (AUROC). Results: We found that both markers are able to recognize thepresence of NAFLD. These are the values obtained for SteatoTest (controls: 0.176±0.0079, NAFLD:0.744±0.166, p<0.001) and for FLI (controls: 80.29±10.53, NAFLD: 91.1±1.89, p<0.001). The AUROCfor the diagnosis of steatosis was 0.811 for SteatoTest (Se: 90.32%, Sp: 67.74%, PPV: 77.8%, NPV:84.8%) and 0.808 for FLI (Se: 98.33%, Sp: 54.55%, PPV: 94.7%, NPV: 79.7%). We also foundSteatoTest and FLI useful for the discrimination between insignificant (S0 and S1) and significantsteatosis (S2 and S3) (p<0.001). Conclusion: SteatoTest and FLI are accurate and easy to use markersfor the diagnosis of steatosis and they allowed differentiation between mild/moderate and severesteatosis.