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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2026; 18(2): 111962
Published online Feb 27, 2026. doi: 10.4254/wjh.v18.i2.111962
Published online Feb 27, 2026. doi: 10.4254/wjh.v18.i2.111962
Performance of three clinical scores for steatosis and steatohepatitis and their interaction with metabolic syndrome in obese individuals
Giovani Schulte Farina, Arturo Tamayo, Tiago Lemos Cerqueira, Ben Min-Woo Illigens, Master’s Program in Clinical Research, Dresden International University, Dresden 01067, Saxony, Germany
Giovani Schulte Farina, Bárbara Brambilla, Emanuelle Mendonça Pandolfo, Laura Kalil Nader Lazzaretti, Stéfano Mateus Schio Kuiava, Ana Maria Graciolli, Vitória Maria Kriger, Carlos Henrique Dal Bem Fistarol, Augusto Cardoso Sgarioni, Henrique Prataviera Giovanardi, School of Medicine, Universidade de Caxias do Sul, Caxias do Sul 95070-560, Rio Grande do Sul, Brazil
Giovani Schulte Farina, Arturo Tamayo, Ben Min-Woo Illigens, Executive and Continuing Professional Education, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
Augusto Cardoso Sgarioni, Henrique Prataviera Giovanardi, Obesity Center, Hospital Geral de Caxias do Sul, Caxias do Sul 95070-561, Rio Grande do Sul, Brazil
Aline Caldart Tregnago, Floriano Riva, Cassiano da Silva Scholze, Department of Pathology, Centro de Patologia Médica Laboratory, Caxias do Sul 95020-170, Rio Grande do Sul, Brazil
Aline Caldart Tregnago, Floriano Riva, Cassiano da Silva Scholze, Department of Pathology, Hospital Geral de Caxias do Sul, Caxias do Sul 95070-561, Rio Grande do Sul, Brazil
Daniel Cecconi Agostini, Department of Radiology, Hospital Geral de Caxias do Sul, Caxias do Sul 95070-561, Rio Grande do Sul, Brazil
Bruno Dellamea, Department of Endocrinology, Universidade de Caxias do Sul, Caxias do Sul 95070-560, RS, Brazil
Jonathan Soldera, Gastroenterology and Acute Medicine, University of South Wales in association with Learna Ltd., Cardiff CF37 1DL, United Kingdom
Jonathan Soldera, Department of Gastroenterology, Logan Hospital, Brisbane 4131, QLD, Australia.
Co-corresponding authors: Giovani Schulte Farina and Jonathan Soldera.
Author contributions: Farina GS and Soldera J contributed equally to this manuscript and are co-corresponding authors. Farina GS, Brambilla B, Pandolfo EM, Giovanardi HP, Sgarioni AC, Tregnago AC, Neto FRR, Scholze CS, Agostini DC, Dellamea BS, and Soldera J conceptualized and designed the study; Farina GS, Brambilla B, Pandolfo EM, Lazzaretti LKN, Kuiava SMS, Graciolli AM, Kriger VM, and Fistarol CHDB performed the data collection; Farina GS, Soldera J, Tamayo A, Cerqueira TL, and Illigens BMW analyzed the data, interpreted the results, and drafted and prepared the manuscript; All authors reviewed the results and approved the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the University of Caxias do Sul Ethics Committee, which approved the study protocol (Protocol No. CAAE 11412219.0.0000.5341).
Informed consent statement: Signed informed consent was obtained from all participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The original anonymized dataset is available upon reasonable request from the corresponding authors at farina.giovanimd@gmail.com or jonathansoldera@gmail.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giovani Schulte Farina, MD, MSc, Master’s Program in Clinical Research, Dresden International University, Freiberger Str. 37, Dresden 01067, Saxony, Germany. farina.giovanimd@gmail.com
Received: July 15, 2025
Revised: August 1, 2025
Accepted: December 18, 2025
Published online: February 27, 2026
Processing time: 212 Days and 14.5 Hours
Revised: August 1, 2025
Accepted: December 18, 2025
Published online: February 27, 2026
Processing time: 212 Days and 14.5 Hours
Core Tip
Core Tip: This study evaluated and optimized the diagnostic performance of three clinical scores - non-alcoholic fatty liver disease liver fat score, Hepatic Steatosis Index, and Fatty Liver Index - for detecting steatosis and steatohepatitis in obese individuals with metabolic dysfunction-associated steatotic liver disease. Using liver biopsy as a reference, we showed that standard thresholds performed poorly, but accuracy improved with optimized cut-offs. Metabolic syndrome status did not affect score performance significantly, suggesting that these tools can be applied across the metabolic dysfunction-associated steatotic liver disease metabolic spectrum. Our findings provide practical insights into improving non-invasive diagnosis in high-risk populations, where early detection is essential but challenging.