Concordance between indirect fibrosis and steatosis indices and their predictors in subjects with overweight/obesity

Background The non-invasive assessment of steatosis/fibrosis tried to overcome some of peri-procedural risk of liver biopsy; for this, several indices of steatosis and fibrosis in liver have been proposed. Aim To evaluate concordance of non-invasive fibrosis and steatosis indices in a large population of adult subjects at risk of NAFLD, and how obesity and its physio-pathological features may interact with steatosis/fibrosis indexes and related biomarkers of cardio-metabolic risk. Methods Indices of steatosis (fatty liver index-FLI), NAFLD liver fat score-NLFS)) and fibrosis (Fibrosis 4 (FIB-4), BARD, BAAT and FORN) were calculated in 1145 outpatients with overweight or obesity at risk for T2D and NAFLD. Indices were correlated with clinical variables. Results Concordance between tests occurred in 81% of the overall values between FLI and NLFS, but was lower when comparing the other fibrosis scores (FIB-4 vs FORN 72%, FIB-4 vs BARD 36%, BARD vs FORN 46%, BARD vs BAAT 58%, FIB-4 vs BAAT 46%, BAAT vs FORN 62%). Each index was differently correlated with anthropometric, clinical and laboratory variables. Conclusion: Indices evaluated retain low concordance, clinicians should be aware of these differences between steatosis/fibrosis scores when expressing a differential liver disease diagnosis or assessing the progression of a known liver disease.

Automated summary

This study aimed to evaluate the concordance of non-invasive fibrosis and steatosis indices in a large population of adult subjects at risk of NAFLD, and how obesity and its physio-pathological features may interact with these indices and related biomarkers of cardio-metabolic risk. The study found that the concordance between different indices was low, and clinicians should take into account these differences when diagnosing liver diseases or assessing disease progression.