Performance of three clinical scores for steatosis and steatohepatitis and their interaction with metabolic syndrome in obese individuals

Figure 1 Non-alcoholic fatty liver disease liver fat score showed a statistically significant difference in the score distribution by any degree of steatosis. All scores presented differences in the distributions by moderate-to-severe steatosis, but only the non-alcoholic fatty liver disease liver fat score (NLFS) and fatty liver index (FLI) were statistically significant. NLFS showed a statistically significant difference in the score distribution by metabolic dysfunction-associated steatohepatitis (MASH). Score distribution was compared by histopathology. A: Distribution of NLFS for any degree of steatosis; B: Distribution of hepatic steatosis index (HSI) for any degree of steatosis; C: Distribution of FLI for any degree of steatosis; D: Distribution of NLFS for moderate-to-severe steatosis; E: Distribution of HSI for moderate-to-severe steatosis; F: Distribution of FLI for moderate-to-severe steatosis; G: Distribution of NLFS for MASH; H: Distribution of HSI for MASH; I: Distribution of FLI for MASH. The horizontal bar represents the median value for each score. Statistics were performed by the Mann-Whitney U test. NLFS: Non-alcoholic fatty liver disease liver fat score; HSI: Hepatic steatosis index; FLI: Fatty liver index; MASH: Metabolic dysfunction-associated steatohepatitis.

Figure 2 Non-alcoholic fatty liver disease liver fat score had the best performance among all scores in detecting any degree of steatosis and metabolic dysfunction-associated steatohepatitis. Performances of the three scores were similar in detecting moderate-to-severe steatosis, with the fatty liver index having a slight advantage. Each score was compared with biopsy-proven scores. A: Any degree of steatosis; B: Moderate-to-severe steatosis; C: Metabolic dysfunction-associated steatohepatitis. AUROC: Area under the receiver operating characteristic curve; NLFS: Non-alcoholic fatty liver disease liver fat score; HSI: Hepatic steatosis index; FLI: Fatty liver index; MASH: Metabolic dysfunction-associated steatohepatitis.