Determination of “indeterminate score” measurements in lean nonalcoholic fatty liver disease patients from western Saudi Arabia

Table 1 Metabolic parameters in the groups classified by body mass index

Variable	Lean	Overweight	Obese	P1
	mean ± SD	mean ± SD	mean ± SD
Age in yr	49.95 ± 15.34	51.34 ± 14.33	53.34 ±13.43	0.0122
BMI	23.14 ± 1.95	27.70 ± 1.71	35.38 ± 4.62	0.174
HbA1c, %	6.07 ± 1.41	6.51 ± 1.61	6.46 ± 1.39	0.290
ALT in U/L	37.14 ± 66.48	32.52 ± 32.16	30.73 ± 30.72	0.924
AST in U/L	28.30 ± 23.81	26.44 ± 26.96	25.04 ± 20.91	0.093
GGT in U/L	60.40 ± 81.59	56.61 ± 81.28	57.58 ± 95.50	0.141
ALKP in U/L	89.56 ± 52.69	79.77 ± 43.69	82.73 ± 38.86	0.132
Total bilirubin in mg/dL	0.74 ± 1.43	0.81 ± 1.61	0.63 ± 1.08	0.227
Direct bilirubin in mg/dL	0.35 ± 0.60	0.40 ± 1.06	0.29 ± 0.65	0.679
Total cholesterol in mg/dL	182.07 ± 48.19	172.69 ± 49.50	175.03 ± 47.37	0.222
LDL in mg/dL	118.84 ± 42.12	114.81 ± 42.00	115.38 ± 41.05	0.022
TG in mg/dL	118.69 ± 79.73	135.74 ± 88.66	132.65 ± 88.56	0.140
HDL in mg/dL	52.56 ± 16.27	47.30 ± 16.96	48.49 ± 16.50	< 0.001
FibroScan, kPa	7.43 ± 7.87	7.01 ± 8.39	8.12 ± 9.49	0.174
NFS	-2.74 ± 3.13	-2.11 ± 2.25	-1.14 ± 2.13	0.290

¹Pairwise comparison using Bonferroni correction, with P-value of < 0.05 indicating statistical significance.

²Comparison using Kruskal-Wallis test, with P-value of < 0.05 indicating statistical significance.

ALKP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; GGT: Gamma-glutamyl transferase; HbA1c: Glycated haemoglobin; HDL: High density lipoprotein; LDL: Low density lipoprotein; NFS: Nonalcoholic fatty liver disease fibrosis score.

Table 2 Frequency of demographic features, metabolic diseases and noninvasive fibrosis assessment findings in the study cohort

Variable	Lean	Overweight	Obese	P1
Sex				0.002
Female	61 (38.4%)	142 (38.9%)	359 (48.7%)
Male	98 (61.6%)	223 (61.1%)	378 (51.3%)
Hyperlipidaemia				< 0.001
Absent	76 (47.8%)	130 (35.6%)	235 (31.9%)
Present	76 (47.8%)	205 (56.2%)	457 (62.0%)
DM				< 0.001
Non-diabetic	103 (64.8%)	171 (46.8%)	294 (39.9%)
Diabetic	50 (31.4%)	171 (46.8%)	405 (55.0%)
HTN				0.002
Normotensive	103 (64.8%)	198 (54.2%)	366 (49.7%)
Hypertensive	50 (31.4%)	144 (39.5%)	333 (45.2%)
NFS reference				< 0.001
F0-F2	85 (53.5%)	173 (47.4%)	256 (34.7%)
F3-F4	5 (3.1%)	16 (4.4%)	84 (11.4%)
Indeterminate score	30 (18.9%)	89 (24.4%)	237 (32.2%)

¹Comparison was done using chi-square test of significance, with P-value of < 0.05 indicating statistical significance. DM: Diabetes mellitus; HTN: Hypertension; NFS: Nonalcoholic fatty liver disease fibrosis score.

Table 3 Agreement between FibroScan and nonalcoholic fatty liver disease fibrosis score among body mass index categories

BMI class	Category	NFS < -1.455	NFS > 0.676	Agreement, κappa
Lean	Low fibrosis	72	1	0.37c
	High fibrosis	10	4
Overweight	Low fibrosis	151	8	0.43c
	High fibrosis	9	8
Obese	Low fibrosis	212	40	0.38c
	High fibrosis	30	38

κappa: Kappa statistic used with ^cP < 0.001. BMI: Body mass index; NFS: Nonalcoholic fatty liver disease fibrosis score.

Table 4 Logistic regression analysis for predictors of indeterminate score according to body mass index class within nonalcoholic fatty liver disease cohort

Variable	Lean			Overweight			Obese
	OR	95%CI	P	OR	95%CI	P	OR	95%CI	P
Age	1.07	1.02, 1.13	0.009b	1.04	1.01, 1.08	0.016	1.03	1.02, 1.05	< 0.001b
HbA1c	1.28	0.84, 1.95	0.257	1.08	0.85, 1.36	0.541
BMI						1.04	1.00, 1.08	.030	1.04
ALT				0.98	0.96, 0.99	0.011	1.00	0.99, 1.00	0.169
Hyperlipidaemia				0.75	0.31, 1.84	0.536	1.01	0.64, 1.57	0.981
LDL				0.99	0.98, 1.00	0.161
DM	0.63	0.17, 2.30	0.484	0.55	0.21, 1.39	0.204	0.99	0.65, 1.50	0.946
HTN	0.61	0.19, 1.96	0.406	1.34	0.61, 2.91	0.464	0.77	0.51, 1.18	0.232

^bP < 0.01. ALT: Alanine aminotransferase; BMI: Body mass index; DM: Diabetes mellitus; HbA1c: Glycated haemoglobin; HTN: Hypertension; LDL: Low density lipoprotein; OR: Odds ratio.