Fatty Liver Index is a valid predictor of non-alcoholic fatty liver disease (NAFLD) in pregnancy.

ABSTRACT

BACKGROUND: Despite the evidence for adverse pregnancy outcomes, non-alcoholic fatty liver disease (NAFLD) is not routinely addressed in early pregnancy. The Fatty Liver Index (FLI) has been proposed as a screening tool for NAFLD in the general population. We aim to develop mathematical models for predicting NAFLD in pregnancy and validate the FLI for first-trimester pregnant women. METHODS: Biochemical and biophysical parameters were analysed in pregnant women with period of gestation <12 weeks was done among Rajarata Pregnancy Cohort, Sri Lanka. Fatty liver was graded as (FLG) 0, I or II by ultrasound scan. Binary logistic regression models were employed to identify the factors predicting FLG-II. Six FLIs were developed to predict FLG-II. Validity of the FLIs was compared using the receiver operating characteristic curves. RESULTS: The study sample consisted of 632 pregnant women with a mean age of 28.8 years (SD 5.8 years). Age (OR 1.6, 95% CI 1.1 to 2.3), body mass index (OR 1.7, 95% CI 1.1 to 2.5) and gamma-glutamyl transferase levels (OR 2.1, 95% CI 1.5 to 3.0) were the independent predictors of FLG-II. While the model with liver enzymes provided the best prediction of NAFLD (both FLG I and II) (area under the curve [(AUC]) -0.734), the highest AUC (0.84) for predicting FLG-II was observed with the full model (model with all parameters). The proposed budget model (AUC >0.81) is the best model for screening fatty liver in community health setup. CONCLUSION: FLIs could be used as screening tools for NAFLD based on resource availability in different settings. External validation of the FLI and further investigation of the proposed FLI as a predictor of adverse pregnancy outcomes are recommended.