External Validation of the Hepatic Steatosis Index for the Detection of Steatotic Liver Disease in Zambia

Liver cancer international Pub Date : 2025-07-29 DOI:10.1002/lci2.70021

Carlotta Mondoka, Guy Muula, Edford Sinkala, Aretha Mumba, Kenan Simumba, Samuel Bosomprah, Carolyn Bolton-Moore, Annalisa Berzigotti, Bernard Surial, Gilles Wandeler, Belinda Varaidzo Chihota, IeDEA-Southern Africa

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Abstract

The hepatic steatosis index (HSI) is used to detect steatotic liver disease (SLD), but its diagnostic performance in African populations is unknown. We performed an external validation of HSI among adults in Zambia. We consecutively screened treatment-naïve people with HIV and individuals without HIV in Zambia using the controlled attenuation parameter (CAP) by vibration controlled transient elastography (VCTE). Model discrimination and calibration were assessed using the c-index and calibration plots. Among 401 participants, 161 (40.1%) were people with HIV. Median age was 37 years (interquartile range 32–43), 244 (60.9%) were female, and 131 (32.7%) were overweight or obese. VCTE-confirmed SLD was present in 41 (10.2%) participants, whereas 92 (22.9%) had an HSI ≥ 36. The c-index to diagnose SLD was 0.67 (95% confidence interval 0.56–0.77). The calibration plot indicated that HSI overestimated the risk for SLD. HSI showed a poor diagnostic performance for the detection of SLD among adults in Zambia.

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赞比亚肝脏脂肪变性指数检测脂肪变性肝病的外部验证

肝脂肪变性指数（HSI）用于检测脂肪变性肝病（SLD），但其在非洲人群中的诊断性能尚不清楚。我们在赞比亚的成年人中进行了HSI的外部验证。采用振动控制瞬态弹性成像（VCTE）控制衰减参数（CAP）连续筛选treatment-naïve赞比亚HIV感染者和非HIV感染者。采用c指数和校正图对模型判别和校正进行评估。在401名参与者中，161人（40.1%）是艾滋病毒感染者。中位年龄37岁（四分位数范围32 ~ 43），女性244例（60.9%），超重或肥胖131例（32.7%）。41名（10.2%）参与者存在vcte确认的SLD，而92名（22.9%）参与者HSI≥36。诊断SLD的c指数为0.67（95%可信区间0.56 ~ 0.77）。校正图显示，HSI高估了SLD的风险。在赞比亚成人中，HSI显示出较差的SLD诊断性能。

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Liver cancer international

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