External validation of fatty liver index for identifying ultrasonographic fatty liver in a large-scale cross-sectional study in Taiwan

Bi Ling Yang, Wen Chieh Wu, Kuan Chieh Fang, Yuan Chen Wang, Teh Ia Huo, Yi Hsiang Huang, Hwai I. Yang, Chien Wei Su, Han Chieh Lin, Fa Yauh Lee, Jaw Ching Wu, Shou Dong Lee

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background and Aims: The fatty liver index (FLI) is an algorithm involving the waist circumference, body mass index, and serum levels of triglyceride and gamma-glutamyl transferase to identify fatty liver. Although some studies have attempted to validate the FLI, few studies have been conducted for external validation among Asians. We attempted to validate FLI to predict ultrasonographic fatty liver in Taiwanese subjects. Methods: We enrolled consecutive subjects who received health check-up services at the Taipei Veterans General Hospital from 2002 to 2009. Ultrasonography was applied to diagnose fatty liver. The ability of the FLI to detect ultrasonographic fatty liver was assessed by analyzing the area under the receiver operating characteristic (AUROC) curve. Results: Among the 29,797 subjects enrolled in this study, fatty liver was diagnosed in 44.5% of the population. Subjects with ultrasonographic fatty liver had a significantly higher FLI than those without fatty liver by multivariate analysis (odds ratio 1.045; 95% confidence interval, CI 1.044-1.047, p < 0.001). Moreover, FLI had the best discriminative ability to identify patients with ultrasonographic fatty liver (AUROC: 0.827, 95% confidence interval, 0.822-0.831). An FLI < 25 (negative likelihood ratio (LR-) 0.32) for males and <10 (LR-0.26) for females rule out ultrasonographic fatty liver. Moreover, an FLI ≥ 35 (positive likelihood ratio (LR+) 3.12) for males and ≥ 20 (LR+ 4.43) for females rule in ultrasonographic fatty liver. Conclusions: FLI could accurately identify ultrasonographic fatty liver in a large-scale population in Taiwan but with lower cut-off value than the Western population. Meanwhile the cut-off value was lower in females than in males.

Original languageEnglish
Article numbere0120443
JournalPLoS One
Volume10
Issue number3
DOIs
Publication statusPublished - Mar 17 2015
Externally publishedYes

Fingerprint

fatty liver
Fatty Liver
Taiwan
cross-sectional studies
Liver
Cross-Sectional Studies
ROC Curve
confidence interval
Confidence Intervals
Population
veterans
Veterans Hospitals
Ultrasonography
gamma-glutamyltransferase
waist circumference

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

External validation of fatty liver index for identifying ultrasonographic fatty liver in a large-scale cross-sectional study in Taiwan. / Yang, Bi Ling; Wu, Wen Chieh; Fang, Kuan Chieh; Wang, Yuan Chen; Huo, Teh Ia; Huang, Yi Hsiang; Yang, Hwai I.; Su, Chien Wei; Lin, Han Chieh; Lee, Fa Yauh; Wu, Jaw Ching; Lee, Shou Dong.

In: PLoS One, Vol. 10, No. 3, e0120443, 17.03.2015.

Research output: Contribution to journalArticle

Yang, BL, Wu, WC, Fang, KC, Wang, YC, Huo, TI, Huang, YH, Yang, HI, Su, CW, Lin, HC, Lee, FY, Wu, JC & Lee, SD 2015, 'External validation of fatty liver index for identifying ultrasonographic fatty liver in a large-scale cross-sectional study in Taiwan', PLoS One, vol. 10, no. 3, e0120443. https://doi.org/10.1371/journal.pone.0120443
Yang, Bi Ling ; Wu, Wen Chieh ; Fang, Kuan Chieh ; Wang, Yuan Chen ; Huo, Teh Ia ; Huang, Yi Hsiang ; Yang, Hwai I. ; Su, Chien Wei ; Lin, Han Chieh ; Lee, Fa Yauh ; Wu, Jaw Ching ; Lee, Shou Dong. / External validation of fatty liver index for identifying ultrasonographic fatty liver in a large-scale cross-sectional study in Taiwan. In: PLoS One. 2015 ; Vol. 10, No. 3.
@article{ac3e34fe48e44088822f38eb700a95e1,
title = "External validation of fatty liver index for identifying ultrasonographic fatty liver in a large-scale cross-sectional study in Taiwan",
abstract = "Background and Aims: The fatty liver index (FLI) is an algorithm involving the waist circumference, body mass index, and serum levels of triglyceride and gamma-glutamyl transferase to identify fatty liver. Although some studies have attempted to validate the FLI, few studies have been conducted for external validation among Asians. We attempted to validate FLI to predict ultrasonographic fatty liver in Taiwanese subjects. Methods: We enrolled consecutive subjects who received health check-up services at the Taipei Veterans General Hospital from 2002 to 2009. Ultrasonography was applied to diagnose fatty liver. The ability of the FLI to detect ultrasonographic fatty liver was assessed by analyzing the area under the receiver operating characteristic (AUROC) curve. Results: Among the 29,797 subjects enrolled in this study, fatty liver was diagnosed in 44.5{\%} of the population. Subjects with ultrasonographic fatty liver had a significantly higher FLI than those without fatty liver by multivariate analysis (odds ratio 1.045; 95{\%} confidence interval, CI 1.044-1.047, p < 0.001). Moreover, FLI had the best discriminative ability to identify patients with ultrasonographic fatty liver (AUROC: 0.827, 95{\%} confidence interval, 0.822-0.831). An FLI < 25 (negative likelihood ratio (LR-) 0.32) for males and <10 (LR-0.26) for females rule out ultrasonographic fatty liver. Moreover, an FLI ≥ 35 (positive likelihood ratio (LR+) 3.12) for males and ≥ 20 (LR+ 4.43) for females rule in ultrasonographic fatty liver. Conclusions: FLI could accurately identify ultrasonographic fatty liver in a large-scale population in Taiwan but with lower cut-off value than the Western population. Meanwhile the cut-off value was lower in females than in males.",
author = "Yang, {Bi Ling} and Wu, {Wen Chieh} and Fang, {Kuan Chieh} and Wang, {Yuan Chen} and Huo, {Teh Ia} and Huang, {Yi Hsiang} and Yang, {Hwai I.} and Su, {Chien Wei} and Lin, {Han Chieh} and Lee, {Fa Yauh} and Wu, {Jaw Ching} and Lee, {Shou Dong}",
year = "2015",
month = "3",
day = "17",
doi = "10.1371/journal.pone.0120443",
language = "English",
volume = "10",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "3",

}

TY - JOUR

T1 - External validation of fatty liver index for identifying ultrasonographic fatty liver in a large-scale cross-sectional study in Taiwan

AU - Yang, Bi Ling

AU - Wu, Wen Chieh

AU - Fang, Kuan Chieh

AU - Wang, Yuan Chen

AU - Huo, Teh Ia

AU - Huang, Yi Hsiang

AU - Yang, Hwai I.

AU - Su, Chien Wei

AU - Lin, Han Chieh

AU - Lee, Fa Yauh

AU - Wu, Jaw Ching

AU - Lee, Shou Dong

PY - 2015/3/17

Y1 - 2015/3/17

N2 - Background and Aims: The fatty liver index (FLI) is an algorithm involving the waist circumference, body mass index, and serum levels of triglyceride and gamma-glutamyl transferase to identify fatty liver. Although some studies have attempted to validate the FLI, few studies have been conducted for external validation among Asians. We attempted to validate FLI to predict ultrasonographic fatty liver in Taiwanese subjects. Methods: We enrolled consecutive subjects who received health check-up services at the Taipei Veterans General Hospital from 2002 to 2009. Ultrasonography was applied to diagnose fatty liver. The ability of the FLI to detect ultrasonographic fatty liver was assessed by analyzing the area under the receiver operating characteristic (AUROC) curve. Results: Among the 29,797 subjects enrolled in this study, fatty liver was diagnosed in 44.5% of the population. Subjects with ultrasonographic fatty liver had a significantly higher FLI than those without fatty liver by multivariate analysis (odds ratio 1.045; 95% confidence interval, CI 1.044-1.047, p < 0.001). Moreover, FLI had the best discriminative ability to identify patients with ultrasonographic fatty liver (AUROC: 0.827, 95% confidence interval, 0.822-0.831). An FLI < 25 (negative likelihood ratio (LR-) 0.32) for males and <10 (LR-0.26) for females rule out ultrasonographic fatty liver. Moreover, an FLI ≥ 35 (positive likelihood ratio (LR+) 3.12) for males and ≥ 20 (LR+ 4.43) for females rule in ultrasonographic fatty liver. Conclusions: FLI could accurately identify ultrasonographic fatty liver in a large-scale population in Taiwan but with lower cut-off value than the Western population. Meanwhile the cut-off value was lower in females than in males.

AB - Background and Aims: The fatty liver index (FLI) is an algorithm involving the waist circumference, body mass index, and serum levels of triglyceride and gamma-glutamyl transferase to identify fatty liver. Although some studies have attempted to validate the FLI, few studies have been conducted for external validation among Asians. We attempted to validate FLI to predict ultrasonographic fatty liver in Taiwanese subjects. Methods: We enrolled consecutive subjects who received health check-up services at the Taipei Veterans General Hospital from 2002 to 2009. Ultrasonography was applied to diagnose fatty liver. The ability of the FLI to detect ultrasonographic fatty liver was assessed by analyzing the area under the receiver operating characteristic (AUROC) curve. Results: Among the 29,797 subjects enrolled in this study, fatty liver was diagnosed in 44.5% of the population. Subjects with ultrasonographic fatty liver had a significantly higher FLI than those without fatty liver by multivariate analysis (odds ratio 1.045; 95% confidence interval, CI 1.044-1.047, p < 0.001). Moreover, FLI had the best discriminative ability to identify patients with ultrasonographic fatty liver (AUROC: 0.827, 95% confidence interval, 0.822-0.831). An FLI < 25 (negative likelihood ratio (LR-) 0.32) for males and <10 (LR-0.26) for females rule out ultrasonographic fatty liver. Moreover, an FLI ≥ 35 (positive likelihood ratio (LR+) 3.12) for males and ≥ 20 (LR+ 4.43) for females rule in ultrasonographic fatty liver. Conclusions: FLI could accurately identify ultrasonographic fatty liver in a large-scale population in Taiwan but with lower cut-off value than the Western population. Meanwhile the cut-off value was lower in females than in males.

UR - http://www.scopus.com/inward/record.url?scp=84924940496&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924940496&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0120443

DO - 10.1371/journal.pone.0120443

M3 - Article

C2 - 25781622

AN - SCOPUS:84924940496

VL - 10

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 3

M1 - e0120443

ER -