Validation of the Fatty Liver Index for identifying non-alcoholic fatty liver disease in a Kenyan population
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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.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Tropical Medicine and International Health |
| Vol/bind | 28 |
| Udgave nummer | 10 |
| Sider (fra-til) | 830-838 |
| Antal sider | 9 |
| ISSN | 1360-2276 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
This specific research did not receive any specific grant from funding agencies in the public, commercial, or not‐for‐profit sectors. André Tchernof is co‐directors of the Research Chair in Bariatric and Metabolic Surgery at Laval University and André Tchernof receives research funding from Johnson & Johnson, Medtronic and GI Windows for studies on bariatric surgery, and acted as consultants for Bausch Health and Novo Nordisk. André Tchernof is consultant for Biotwin. Marie‐Eve Piché is recipient of a Junior 1 clinician‐researcher scholar from the Fonds de Recherche du Quebec‐Sante (FRQS). Dirk L. Christensen has acted as consultant for Novo Nordisk Mexico.
Funding Information:
We are grateful to all study participants, the local chiefs and sub‐chiefs, the local elder councils and district politicians. We kindly thank all local assistants for their excellent work of mobilising participants as well as assisting in doing measurements of anthropometry and body composition. A special thanks to Dr. Andreas W. Hansen who performed parts of the abdominal ultrasound scans. We are grateful for funding to EDLR, who is supported by the NIHR Cambridge Biomedical Research Centre (IS‐BRC‐1215‐20014). Likewise, we are grateful to the general contributions to the Kenya Diabetes Study by Professor Knut Borch‐Johnsen, Professor Inge Tetens, Professor Henrik Friis and Dr. David L. Mwaniki. Funding was received from DANIDA (J. no.104.DAN.8–871, RUF project no. 91202), University of Copenhagen (Cluster of International Health), Steno Diabetes Center Copenhagen, Beckett Foundation, Dagmar Marshall's Foundation, Dr. Thorvald Madsen's Grant for the Advancement of MedicalSciences, Kong Christian den Tiende's Foundation and Brdr. Hartmann Foundation.
Publisher Copyright:
© 2023 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
ID: 365703978