Table 3. Summary of biomarker-based prediction models to assess hepatic steatosis.
| Indices | Equations | Cut-points | Development cohort | External validation |
|---|---|---|---|---|
| FLI (2006) [81] | =1/[1+exp (−Y)]×100, Y=0.953×loge (TG, mg/dL)+0.139×BMI+0.718×loge (GGT, U/L)+0.053×WC− 15.745 | ≥60, <30 | NAFLD by US (Italy) | Yes (validated in Korean) |
| SteatoTest (2005) [82] | α2-Macroglobulin, haptoglobin, apolipoprotein A1, total bilirubin, GGT, FPG, TG, cholesterol, ALT, age, sex, BMI | NA | NAFLD by biopsy (France) | Yes |
| NAFLD liver fat score (2009) [83] | =−2.89+1.18×MetS+0.45×diabetes (yes=2/no=0)+0.15×(fSinsulin, μU/L)+ 0.04×AST+0.94×AST/ALT | >−0.64 | NAFLD by MRS (Finland) | Yes (validated in Korean) |
| HIS (2010) [84] | =8×ALT/AST+BMI (+2, if diabetes; +2, if female) | ≥36, <30 | NAFLD by US (Korean) | Yes (validated in Korean) |
| CNS (2014) [80] | =1/[1+exp (−Y)]×100 | ≥40 | NAFLD by US (Korean) | Yes (validated in Korean) |
| Y (male)=0.016×age+0.182×BMI+0.089×WC+0.391×alcohol+0.124×exercise (yes=0/no=1)+0.018×FPG (mg/dL)+0.773×loge (TG, mg/dL)−0.014×HDL-C (mg/dL)+0.145×uric acid (mg/dL)−0.674×loge (AST)+1.632×loge (ALT)−21.695 | ||||
| Y (female)=0.320×BMI+0.044×WC+0.533×diabetes+0.016×FPG+0.951×loge (TG)−0.015×HDL-C+0.199×uric acid−0.645×loge (AST)+1.302×loge (ALT)+0.255×menopause−19.741 | ||||
| SNS (2014) [80] | =Points, Age ≥35=1 | ≥8 | NAFLD by US (Korean) | Yes (validated in Korean) |
| WC (male)=80–89/90–99/≥100=2/3/4 | ||||
| WC (female)=75–84/85–94/≥95=1/2/3 | ||||
| BMI (male)=23–24/25–26/≥27=1/2/3 | ||||
| BMI (female)=23–24/25–26/≥27=2/3/4 | ||||
| Diabetes=2 | ||||
| Dyslipidemia=2 | ||||
| No regular exercise=1 | ||||
| Alcohol=1 for male | ||||
| Menopause=1 for female | ||||
| ZJU index (2015) [85] | =BMI+FPG (mmol/L)+TG (mmol/L)+3×ALT/AST (+2, if female) | > 38, <32 | NAFLD by US (China) | Yes |
| FSI (2016) [86] | =−7.981+0.011×age (years)−0.146×sex (female=1, male=0)+0.173× BMI+0.007×TG (mg/dL)+0.593×hypertension+0.789×diabetes+1.1×ALT/AST ratio ≥1.33 (yes=1, no=0) | ≥23 | NAFLD by CT (USA) | Yes |
| Chinese NAFLD score (2016) [87] | =−4.632+0.303×MetS+0.157×T2DM (yes =2, no=0)+0.078×fSinsulin (μU/L)+0.168×BMI−0.879×AST/ALT | >−0.79 | NAFLD by US (China) | Yes |
FLA, fatty liver index; TG, triglyceride; BMI, body mass index; GGT, γ-glutamyltransferase; WC, waist circumference; NAFLD, nonalcoholic fatty liver disease; US, ultrasonography; FPG, fasting plasma glucose; ALT, alanine aminotransferase; NA, not available; MetS, metabolic syndrome; fSinsulin, fasting serum insulin; AST, aspartate aminotransferase; MRS, magnetic resonance spectroscopy; HSI, hepatic steatosis index; CNS, comprehensive NAFLD score; HDL-C, high density lipoprotein cholesterol; SNS, simple NAFLD score; ZJU, Zhejiang University; FSI, Framingham Steatosis Index; CT, computed tomography; T2DM, type 2 diabetes mellitus.