Bhatt et al reported two scores for the diagnosis of nonalcoholic fatty liver disease (NAFLD) in obese Asian Indians. This can help to identify a patient who may benefit from more aggressive management. The authors are from the Diabetic Foundation, National Diabetes Obesity and Cholesterol Foundation, All India Institute of Medical Sciences, Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases and Endocrinology and the Council of Scientific & Industrial Research-Institute of Genomics and Integrative Biology in India.
Patient selection: non-diabetic Asian Indians
Outcome: NAFLD
Parameters:
(1) double chin
(2) buffalo hump (excessive dorsocervical fat)
(3) systolic blood pressure in mm Hg
(4) serum triglycerides in mg/dL
(5) serum insulin in mU/L
|
Parameter
|
Finding
|
Points for Clinical Score
|
Points for Clinical and Biochemical Score
|
|
double chin
|
absent
|
0
|
NA
|
|
|
present
|
1
|
NA
|
|
buffalo hump
|
absent
|
0
|
0
|
|
|
present
|
13.8
|
18
|
|
systolic blood pressure
|
<= 120/80 mm Hg
|
0
|
0
|
|
|
> 120/80 mm Hg
|
15.5
|
16
|
|
serum TG
|
< 150 mg/dL
|
NA
|
0
|
|
|
>= 150 mg/dL
|
NA
|
1
|
|
serum insulin
|
<= 2.7 mU/L
|
NA
|
0
|
|
|
> 2.7 mU/L
|
NA
|
12
|
total clinical score =
= SUM(points for all 3 parameters)
total clinical and biochemical score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum clinical or clinical and biochemical scores: 0
• maximum clinical score: 30.3 (stated as 28.7 in paper)
• maximum clinical and biochemical score: 47
• A clinical and biochemical score >= 12 had a sensitivity of 64% and specificity of 67%.
Performance:
• The area under the ROC curve was 0.72.
