Validation of the Fatty Liver Index for identifying non-alcoholic fatty liver disease in a Kenyan population

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  • Fannie Lajeunesse-Trempe
  • Michael K. Boit
  • Lydia U. Kaduka
  • Emanuella De Lucia-Rolfe
  • Alexis Baass
  • Martine Paquette
  • Marie Eve Piché
  • André Tchernof
  • Christensen, Dirk Lund

Background and Aim: Fatty Liver Index (FLI) is a simple clinical scoring system estimating non-alcoholic fatty liver disease (NAFLD). It is validated in European-descent and Asian populations, but not in sub-Saharan Africans. The aim of this study is to evaluate the validity of the FLI for predicting NAFLD in a population from Kenya. Methods: Participants were recruited from a community-based study conducted in Kenya. NAFLD was diagnosed using hepatic ultrasonography. Clinical, anthropometrical, biochemical and lifestyle data were obtained. The accuracy and cut-off point of the FLI to detect NAFLD were evaluated by area under the receiver operator characteristic curve and the maximum Youden index analysis. Results: A total of 640 participants (94 with NAFLD) were included. Mean age was 37.4 ± 0.4 years and 58.7% were women. Mean body mass index (BMI) was 22.3 ± 0.2 kg/m2 and waist circumference (WC) 79.1 ± 0.4 cm. A total of 15 (2.3%) participants were diagnosed with type 2 diabetes and 65 (10.2%) with obesity (BMI ≥ 30 kg/m2). AUROC of FLI for predicting NAFLD was 0.80 (95% CI 0.74–0.85), which was significantly higher compared to individual components gamma-glutamyl transferase and triglycerides (p < 0.05), but not compared to anthropometric parameters BMI (AUROC of 0.83, 95% CI 0.79–0.88) and WC (AUROC of 0.81, 95% CI 0.76–0.87). Conclusions: FLI is a simple valid scoring system to use in rural and urban Kenyan adults. However, this index might not be superior to BMI or WC to predict NAFLD, and those measurements might therefore be more appropriate in limited settings.

Original languageEnglish
JournalTropical Medicine and International Health
Volume28
Issue number10
Pages (from-to)830-838
Number of pages9
ISSN1360-2276
DOIs
Publication statusPublished - 2023

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© 2023 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

    Research areas

  • African populations, ethnicity, Fatty Liver Index, hepatic steatosis, non-alcoholic fatty liver disease

ID: 365703978