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Open AccessArticle

Comparative Assessment and External Validation of Hepatic Steatosis Formulae in a Community-Based Setting

1
Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
2
Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
*
Authors to whom correspondence should be addressed.
These authors are co-first authors and contributed equally to this work.
J. Clin. Med. 2020, 9(9), 2851; https://doi.org/10.3390/jcm9092851
Received: 14 July 2020 / Revised: 31 August 2020 / Accepted: 1 September 2020 / Published: 3 September 2020
Several hepatic steatosis formulae have been validated in various cohorts using ultrasonography. However, none of these studies has been validated in a community-based setting using the gold standard method. Thus, the aim of this study was to externally validate hepatic steatosis formulae in community-based settings using magnetic resonance imaging (MRI). A total of 1301 community-based health checkup subjects who underwent liver fat quantification with MRI were enrolled in this study. Diagnostic performance was assessed using the area under the receiver operating characteristic curve (AUROC). Non-alcoholic fatty liver disease (NAFLD) liver fat score showed the highest diagnostic performance with an AUROC of 0.72, followed by Framingham steatosis index (0.70), hepatic steatosis index (HSI, 0.69), ZJU index (0.69), and fatty liver index (FLI, 0.68). There were considerable gray zones in three fatty liver prediction models using two cutoffs (FLI, 28.9%; HSI, 48.9%; and ZJU index, 53.6%). The diagnostic performance of NAFLD liver fat score for detecting steatosis was comparable to that of ultrasonography. The diagnostic agreement was 72.7% between NAFLD liver fat score and 70.9% between ultrasound and MRI. In conclusion, the NAFLD liver fat score showed the best diagnostic performance for detecting hepatic steatosis. Its diagnostic performance was comparable to that of ultrasonography in a community-based setting. View Full-Text
Keywords: non-alcoholic fatty liver disease; fatty liver; validation study; population groups; magnetic resonance imaging non-alcoholic fatty liver disease; fatty liver; validation study; population groups; magnetic resonance imaging
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Jung, T.Y.; Kim, M.S.; Hong, H.P.; Kang, K.A.; Jun, D.W. Comparative Assessment and External Validation of Hepatic Steatosis Formulae in a Community-Based Setting. J. Clin. Med. 2020, 9, 2851.

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