Performance of Simple Outpatient-based Biomarker Panels for Screening of Steatotic Liver Disease in Women with Morbid Obesity from Southern India.

Background: Non-alcoholic fatty liver disease (NAFLD) and related health issues are increasing in Indian women with morbid obesity, but the standard diagnostic tool - abdominal ultrasound sonography (USG) - is costly and less accessible. This study aims to identify an affordable and effective biomarker panel to improve early detection and screening of NAFLD in resource-l imited settings.

Methods: This cross-sectional study included 106 consecutive patients aged between 18 and 70 years with morbid obesity defined by body mass index (BMI) ≥32.5 kg/m² who underwent an abdominal USG for a non-hepatic indication. The serum biomarker indices used were hepatic steatosis index, lipid accumulation product (LAP), Framingham steatosis index, triglyceride-glucose (TyG) index, TyG weight-to-height ratio composite index, TyG-BMI and TyG waist circumference composite index.

Results: The mean age was 40.2 ± 10.9 years, and the mean BMI was 41.5 ± 5.8 kg/m². NAFLD was diagnosed in 71.7% of the participants. The TyG index showed the highest diagnostic accuracy with an area under the receiver operating characteristic curve (AUROC) of 0.835 (confidence interval [CI]: 0.713-0.957, p<0.001), with a sensitivity of 95.1% and a specificity of 70.8% at a cut-off of 9.0994. LAP showed an AUROC of 0.711 (CI: 0.584-0.838, p-value: 0.002). Using a cut-off score of 76.2, the sensitivity and specificity were 71.2 and 70.8%, respectively.

Conclusion: Simple screening tools can be used to detect fatty liver disease in clinical practice. In our cohort, TyG index was found to be the best tool for identifying NAFLD, with LAP showing potential as a secondary option.