Abstract
SummaryBackgroundAlanine-aminotransferase (ALT) and uric acid cut-off levels used in non-alcoholic fatty liver disease (NAFLD) diagnosis are advised to be lowered. Due to contradictory results on the utility of both these biomarkers for NAFLD screening, we aimed to determine their cut-off levels that can be applied to Montenegrin population with the fatty liver disease.MethodsA total of 771 volunteers were enrolled. A fatty liver index (FLI) score ≥60 was used as proxy of NAFLD. The receiver operating characteristic curve analysis with the area under the curve (AUC) was used to determine the cut-off values of ALT and uric acid associated with FLI ≥60.ResultsALT was independent predictor of FLI in both men and women, whereas serum uric acid was its independent predictor only in women. Lower cut-off levels of ALT are associated with the increased prevalence of NAFLD [i.e., ALT was 19 IU/L (AUC=0.746, sensitivity 63%, specificity 72%, P<0.001) in women and 22 IU/L (AUC=0.804, sensitivity 61%, specificity 95%, P<0.001) in men]. The cut-off value for uric acid was 274 μmol/L (AUC=0.821, sensitivity 68%, specificity 82%, P<0.001) in women.ConclusionsLower cut-off levels of ALT in both genders, and serum uric acid in females, can be reliable predictors of the FLI.
Highlights
It is widely recognized that non-alcoholic fatty liver disease (NAFLD) represents the commonest manifestation of chronic liver diseases [1]
Alanine-aminotransferase (ALT) and uric acid cut-off levels used in non-alcoholic fatty liver disease (NAFLD) diagnosis are advised to be lowered
A fatty liver index (FLI) score ≥60 was used as proxy of NAFLD
Summary
It is widely recognized that non-alcoholic fatty liver disease (NAFLD) represents the commonest manifestation of chronic liver diseases [1]. Its prevalence is rising along with the growing proportion of obesity and diabetes mellitus type 2 (DM2) worldwide It looks like a benign condition, without any symptoms, during a certain time NAFLD increases the risk of cirrhosis and hepatocellular carcinoma [1]. It is an early predictor of diabetic complications and cardiovascular disease (CVD) [2, 3]. Due to its invasive diagnostic nature it is not suitable procedure in routine everyday praxis It has been replaced with abdominal ultrasonography, as the commonest technique for NAFLD assessment in clinical trials. An FLI score ≥60 has been shown to have good sensitivity and specificity for NAFLD when diagnosed by abdominal ultrasonography, making it suitable for assessment hepatic steatosis in general population [5, 6]
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