Steatosis tests
| Investigation panel name | Commercial | Formula and variables | AUROC | Sensitivity (Se) and specificity (Sp) | Comments | Primary reference |
|---|---|---|---|---|---|---|
| Steatotest | Yes | Patented algorithm including: ALT, A2M, ApoA1, haptoglobin, total bilirubin, GGT, cholesterol, TG, glucose, age, gender and BMI | 0.72–0.86 | To detect grade ≥2 steatosis: Threshold >0.3: Se 0.85–1; Threshold >0.7: Sp 0.83–1 | Modest diagnostic ability for moderate/severe steatosis. Subsequent meta-analysis AUROC 0.71 (0.66–0.75)60 | 61 |
| Fatty Liver Index | No | Algorithm based on BMI, waist circumference, TG and GGT | 0.84 | Thresholds <30 (exclude) and >60 (confirm) steatosis: Se 0.87, Sp 0.86 | Based on ultrasound detected steatosis as the standard. | 62 |
| NAFLD liver fat score | No | Algorithm based on presence of the metabolic syndrome and T2DM, fS insulin, fS-AST, and AST/ALT ratio | 0.87 | −0.640 predicted increased liver fat content: Se 0.86, Sp 0.71 | Validated in a separate study by another group63 | 64 |
| Lipid Accumulation Product | No | Males: (waist circumference (cm)—65)×TG Females: (waist circumference—58)×TG | – | Steatosis OR increases×4.28 for each 1 log rise | 65 |
A2M, α2-macroglobulin; ALT, alanine aminotransferase; ApoA1, apolipoprotein A-I; AST, aspartate aminotransferase; AUROC, area under the receiver operating characteristic curve; BMI, body mass index; fS, fasting serum; GGT, gamma-glutamyltransferase; NAFLD, non-alcoholic fatty liver disease; T2DM, type 2 diabetes mellitus; TG, triglycerides.