Development of a simple nonalcoholic fatty liver disease scoring system indicative of metabolic risks and insulin resistance

Background: Nonalcoholic fatty liver disease (NAFLD) is estimated to affect approximately 30% population worldwide. However, there is yet a basic and generally implementable approach to define individuals at risk for NAFLD estimative of metabolic risk. Methods: Total of 3,634 general participants without history of liver disease and alcohol consumption who received the Korean National Health and Nutrition Examination Survey between 2008 and 2010 were studied. Logistic regression was used to identify significant covariates indicative of NAFLD. Multivariable-adjusted logistic regression was carried out for evaluation on estimative impact of the derived score on metabolic risks. Results: Sex [female; odd ratio (OR), 2.492; 95% confidence interval (CI), 1.921-3.233; P<0.001], waist circumference (WC) (OR, 1.093; 95% CI, 1.077-1.110, P<0.001) systolic blood pressure (OR, 1.033; 95% CI, 1.025-1.040; P<0.001), fasting serum glucose ( FSG) (OR, 1.032; 95% CI, 1.026-1.038; P<0.001), triglyceride (OR, 1.007; 95% CI, 1.006-1.009; P<0.001), and alanine aminotransferase (OR, 1.110; 95% CI, 1.097-1.124; P<0.001) were independently indicative of NAFLD, which constituted the derived scoring system. The system revealed a significant correlation with the NAFLD liver fat score, fatty liver index (FLI), body mass index, age, alanine aminotransferase, and triglycerides (BAAT) score, lipid accumulation product, and hepatic steatosis index. In addition, the derived score was significantly estimative of insulin resistance. Conclusions: The developed score may be supportive of stratification of individuals at high risk of NAFLD, non-invasive fast diagnosis of NAFLD, and estimation of metabolic risk. Future studies that compare the derived score with standard diagnostic tests-validated data, such as ultrasonography of the liver, are needed.