{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:57:44Z","timestamp":1791557864345,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T00:00:00Z","timestamp":1647388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Non\u2010invasive hepatic steatosis algorithms are recommended in detecting metabolic\u2010associated fatty liver disease (MAFLD) in epidemiological studies. However, the diagnostic accuracy of these models is unclear. This study aimed to evaluate the diagnostic efficiency of five common models in a national survey population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Third National Health and Nutrition Examination Survey (NHANES III) datasets were used in this study. The fatty liver index (FLI), hepatic steatosis index (HSI), non\u2010alcoholic liver disease\u2010liver fat score (NAFLD\u2010LFS), the steato text (ST), and visceral adiposity index (VAI) were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of MAFLD in the general population was 31.2%. The proportion of MAFLD estimated using the NAFLD\u2010LFS (30.8%) was the closest to the real number, whereas the ST model (66.1%) significantly overestimated the prevalence of MAFLD in this cohort. The FLI (36.9%) and HSI models (38.5%) also slightly overestimated the prevalence of MAFLD in the study population. The FLI had the highest area under the receiver operating characteristic (AUROC) value (0.793) among all models, with a sensitivity of 57.0%, a specificity of 83.8%, a positive predictive value (PPV) of 67.3%, and a negative predictive value (NPV) of 77.0%. The combination of the original algorithm with additional metabolic dysfunction criteria did not improve the diagnostic efficiency. The discriminative ability for MAFLD in all models was lower in participants with a normal body mass index (BMI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Non\u2010invasive models, especially the FLI, have satisfactory diagnostic performance in detecting MAFLD. However, models in people with normal BMIs require further development.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15799","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T06:59:13Z","timestamp":1645081153000},"page":"938-945","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Validation of five hepatic steatosis algorithms in metabolic\u2010associated fatty liver disease: A population based study"],"prefix":"10.1111","volume":"37","author":[{"given":"Yuxiu","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Hepatology Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hepatology Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University  Fuzhou China"},{"name":"Department of Gastroenterology The First Hospital of Nanping City  Nanping China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaofeng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Hepatology Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University  Fuzhou China"},{"name":"Clinical Research Center for Liver and Intestinal Diseases of Fujian Province  Fuzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueyong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Hepatology Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University  Fuzhou China"},{"name":"Clinical Research Center for Liver and Intestinal Diseases of Fujian Province  Fuzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7517-9859","authenticated-orcid":false,"given":"Su","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Hepatology Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University  Fuzhou China"},{"name":"Clinical Research Center for Liver and Intestinal Diseases of Fujian Province  Fuzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,16]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(19)30039-1"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.04.006"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000282080"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12923"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.11.312"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-020-10094-2"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14548"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2020.154433"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.05.029"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i30.3361"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13857"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-6-33"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2009.08.002"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.06.005"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001682"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.12.031"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000007610"},{"key":"e_1_2_5_19_1","article-title":"The severity of ultrasonographic findings in nonalcoholic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation","volume":"102","author":"Hamaguchi M","year":"2007","journal-title":"Official journal of the American College of Gastroenterology"},{"key":"e_1_2_5_20_1","first-page":"1","article-title":"Obesity: preventing and managing the global epidemic. 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