Calc Function

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    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
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    Patent Pending

    Fatty Liver Index

    Diagnoses fatty liver using labs and exam findings.
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    When to Use
    Pearls/Pitfalls
    Why Use

    Patients in whom fatty liver (e.g. alcoholic fatty liver, NAFLD, NASH) is suspected.

    • Among liver enzymes, GGT was the only independent predictor of fatty liver in the original study, though it is not always part of routine liver enzymes across settings.
    • Originally derived in a Northern Italian cohort but has since been validated in multiple cohorts including North America, China, and the UK.
    • May help in patient selection for ultrasound or liver biopsy.
    • Validated in multiple external cohorts.
    • May be used in the research setting to identify patients for planning observational or interventional studies.
    kg/m²
    in
    U/L
    mg/dL

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    Consider ultrasound for confirmation/clarification in patients with indeterminate or high FLI.

    Formula

    Fatty Liver Index (FLI) = ey / (1 + ey) × 100

    Where y = 0.953 × ln(triglycerides, mg/dL) + 0.139 × BMI, kg/m2 + 0.718 × ln (GGT, U/L) + 0.053 × waist circumference, cm – 15.745)

    Facts & Figures

    Interpretation:

    Fatty Liver Index

    Risk

    Diagnosis

    <30

    Low

    Fatty liver ruled out (LR- = 0.2)

    30 to <60

    Indeterminate

    Fatty liver neither ruled in nor ruled out

    ≥60

    High

    Fatty liver ruled in (LR+ = 4.3)


    Literature

    Validation

    Research PaperCuthbertson DJ, Weickert MO, Lythgoe D, et al. External validation of the fatty liver index and lipid accumulation product indices, using 1H-magnetic resonance spectroscopy, to identify hepatic steatosis in healthy controls and obese, insulin-resistant individuals. Eur J Endocrinol. 2014;171(5):561-9.Research PaperKoehler EM, Schouten JN, Hansen BE, Hofman A, Stricker BH, Janssen HL. External validation of the fatty liver index for identifying nonalcoholic fatty liver disease in a population-based study. Clin Gastroenterol Hepatol. 2013;11(9):1201-4.Research PaperHuang X, Xu M, Chen Y, et al. Validation of the Fatty Liver Index for Nonalcoholic Fatty Liver Disease in Middle-Aged and Elderly Chinese. Medicine (Baltimore). 2015;94(40):e1682.Research PaperYang BL, Wu WC, Fang KC, et al. External validation of fatty liver index for identifying ultrasonographic fatty liver in a large-scale cross-sectional study in Taiwan. PLoS ONE. 2015;10(3):e0120443.
    Dr. Giorgio Bedogni

    About the Creator

    Giorgio Bedogni, MD, is an internist and researcher at the Liver Research Center in Trieste, Italy. He is also a scientific consultant at the Romeo and Enrica Pediatric Research Center, CEINGE - Advanced Biotechnology, and the International Center for the Assessment of Nutritional Status (ICANS). Dr. Bedogni's primary research interests include fatty liver disease and nutrition.

    To view Dr. Giorgio Bedogni's publications, visit PubMed