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Fatty liver biomarkers and insulin resistance indices in the prediction of non‐alcoholic fatty liver disease in Ghanaian patients
BACKGROUND: Scant West African data on non‐alcoholic fatty liver disease (NAFLD) means there is little representation of this population in the modelling used to derive biomarkers and predictive indices for risk stratification of patients for the presence of hepatic steatosis. This study evaluates t...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638625/ https://www.ncbi.nlm.nih.gov/pubmed/37814510 http://dx.doi.org/10.1002/edm2.456 |
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author | Bockarie, A. S. Nartey, Y. A. Nsiah, P. Edzie, E. K. M. Tuoyire, D. Acquah, S. Eliason, S. Nkum, B. |
author_facet | Bockarie, A. S. Nartey, Y. A. Nsiah, P. Edzie, E. K. M. Tuoyire, D. Acquah, S. Eliason, S. Nkum, B. |
author_sort | Bockarie, A. S. |
collection | PubMed |
description | BACKGROUND: Scant West African data on non‐alcoholic fatty liver disease (NAFLD) means there is little representation of this population in the modelling used to derive biomarkers and predictive indices for risk stratification of patients for the presence of hepatic steatosis. This study evaluates the performance of the fatty liver index (FLI), hepatic steatosis index (HSI) and triglyceride‐glucose (TyG) index and its derivatives in predicting ultrasound detected NAFLD in a locally resident population of Ghanaian participants. METHODS AND FINDINGS: A post hoc analysis of data from a cross sectional assessment of NAFLD and cardiovascular risk was performed. Data from 210 participants without significant alcohol intake, or secondary causes of fatty liver and not on steatogenic drugs was evaluated. A structured questionnaire had been used to collect demographic data, medical and drug history. Anthropometry, blood sampling for liver chemistry and fasting lipids were performed. Hepatic steatosis was detected by ultrasonography. A retrospective analysis involving multivariate binary logistic regression assessed FLI, HIS, TyG (and its derivatives) as predictors of NAFLD with p < .05 considered statistically significant. Sensitivity, specificity, predictive values, likelihood ratios were calculated and accuracy of the proxies evaluated from area under the receiver operating characteristics curve (AUROC). All the biomarkers and indices were significantly associated with NAFLD (p ≤ .001). All the lipid and fatty liver indices assessed performed acceptably as predictors of NAFLD. FLI (AUC = 0.8, 95% CI [0.74–0.87]), TyG‐WC (AUC = 0.81, 95% CI [0.75–0.88]) and TyG‐WHtR (AUC = 0.81, 95% CI [0.74–0.88]) performed best at predicting NAFLD. Whilst in all cases the markers had good specificity (>90%) they lacked sufficient sensitivity with FLI having the highest sensitivity of 36.7%. Their overall accuracy was greater than 70% in each case. CONCLUSION: The overall accuracy of HSI, FLI, TyG index and its derivatives (TyG WHtR, TyG BMI, TyG WC) was acceptable for predicting NAFLD in this population. Given their performance in this study and in light of their low cost, accessibility, easy interpretation and non‐invasive nature; they are suitable tools for screening in the Ghanaian population. |
format | Online Article Text |
id | pubmed-10638625 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-106386252023-11-15 Fatty liver biomarkers and insulin resistance indices in the prediction of non‐alcoholic fatty liver disease in Ghanaian patients Bockarie, A. S. Nartey, Y. A. Nsiah, P. Edzie, E. K. M. Tuoyire, D. Acquah, S. Eliason, S. Nkum, B. Endocrinol Diabetes Metab Research Articles BACKGROUND: Scant West African data on non‐alcoholic fatty liver disease (NAFLD) means there is little representation of this population in the modelling used to derive biomarkers and predictive indices for risk stratification of patients for the presence of hepatic steatosis. This study evaluates the performance of the fatty liver index (FLI), hepatic steatosis index (HSI) and triglyceride‐glucose (TyG) index and its derivatives in predicting ultrasound detected NAFLD in a locally resident population of Ghanaian participants. METHODS AND FINDINGS: A post hoc analysis of data from a cross sectional assessment of NAFLD and cardiovascular risk was performed. Data from 210 participants without significant alcohol intake, or secondary causes of fatty liver and not on steatogenic drugs was evaluated. A structured questionnaire had been used to collect demographic data, medical and drug history. Anthropometry, blood sampling for liver chemistry and fasting lipids were performed. Hepatic steatosis was detected by ultrasonography. A retrospective analysis involving multivariate binary logistic regression assessed FLI, HIS, TyG (and its derivatives) as predictors of NAFLD with p < .05 considered statistically significant. Sensitivity, specificity, predictive values, likelihood ratios were calculated and accuracy of the proxies evaluated from area under the receiver operating characteristics curve (AUROC). All the biomarkers and indices were significantly associated with NAFLD (p ≤ .001). All the lipid and fatty liver indices assessed performed acceptably as predictors of NAFLD. FLI (AUC = 0.8, 95% CI [0.74–0.87]), TyG‐WC (AUC = 0.81, 95% CI [0.75–0.88]) and TyG‐WHtR (AUC = 0.81, 95% CI [0.74–0.88]) performed best at predicting NAFLD. Whilst in all cases the markers had good specificity (>90%) they lacked sufficient sensitivity with FLI having the highest sensitivity of 36.7%. Their overall accuracy was greater than 70% in each case. CONCLUSION: The overall accuracy of HSI, FLI, TyG index and its derivatives (TyG WHtR, TyG BMI, TyG WC) was acceptable for predicting NAFLD in this population. Given their performance in this study and in light of their low cost, accessibility, easy interpretation and non‐invasive nature; they are suitable tools for screening in the Ghanaian population. John Wiley and Sons Inc. 2023-10-09 /pmc/articles/PMC10638625/ /pubmed/37814510 http://dx.doi.org/10.1002/edm2.456 Text en © 2023 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Articles Bockarie, A. S. Nartey, Y. A. Nsiah, P. Edzie, E. K. M. Tuoyire, D. Acquah, S. Eliason, S. Nkum, B. Fatty liver biomarkers and insulin resistance indices in the prediction of non‐alcoholic fatty liver disease in Ghanaian patients |
title | Fatty liver biomarkers and insulin resistance indices in the prediction of non‐alcoholic fatty liver disease in Ghanaian patients |
title_full | Fatty liver biomarkers and insulin resistance indices in the prediction of non‐alcoholic fatty liver disease in Ghanaian patients |
title_fullStr | Fatty liver biomarkers and insulin resistance indices in the prediction of non‐alcoholic fatty liver disease in Ghanaian patients |
title_full_unstemmed | Fatty liver biomarkers and insulin resistance indices in the prediction of non‐alcoholic fatty liver disease in Ghanaian patients |
title_short | Fatty liver biomarkers and insulin resistance indices in the prediction of non‐alcoholic fatty liver disease in Ghanaian patients |
title_sort | fatty liver biomarkers and insulin resistance indices in the prediction of non‐alcoholic fatty liver disease in ghanaian patients |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638625/ https://www.ncbi.nlm.nih.gov/pubmed/37814510 http://dx.doi.org/10.1002/edm2.456 |
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