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Abstract

Background:   Several non-interventional imaging studies, scoring systems, and biochemical markers are widely used nowadays to urgently diagnose stage and manage cases of non-alcoholic fatty liver disease (NAFLD) to avoid potential complications. The current study aimed to compare the sensitivity, specificity, and positive predictive values (PPR) of some widely used NAFLD-induced steatosis scoring systems. Methods:  Fifty patients confirmed with fatty liver by ultrasonography were recruited in this study. All patients underwent steatosis staging using FibroScan. For all patients, aspartate transaminase (AST), alanine transaminase (ALT), platelet count, and body mass index were measured for the calculation of aspartate transaminase to platelet ratio index (APRI), hepatic steatosis index (HSI), and AST/ALT equations. Sensitivity, specificity, and PPR for the three scoring systems were calculated compared to FibroScan scoring results as the standard validating system where S0 and S1 scores were considered negative while S2 and S3 scores were considered positive for hepatic steatosis. Results:  Sensitivity results were 45, 87.8, and 45.9%; specificity results were 30, 22.2, and 69.2%; and PPR results were 72, 83.7, and 82.9% for APRI, HSI, and AST/ALT ratio scoring equation, respectively. Conclusion:  Among the three steatosis scoring systems studied in the present study, the HSI was the most sensitive scoring system, and the AST/ALT ratio was the most specific scoring system compared to the FibroScan as the standard steatosis scoring system. Keywords: Equational Scores; Steatosis; Elastography; AST/ALT; APRI