Diagnostic accuracy of noninvasive steatosis biomarkers with magnetic resonance imaging proton density fat fraction as gold standard

Table 3 The diagnostic accuracy of each steatosis biomarkers in identifying nonalcoholic fatty liver disease as defined by magnetic resonance imaging proton density fat fraction ≥ 5%

Biomarkers	AUC (95%CI)	Cut-off1	Youden index	SE, %	SP, %	PLR	NLR	PPV, %	NPV, %	Accuracy, %
FLI	0.899 (0.832-0.966)	≥ 42	0.701	84.4	85.7	5.91	0.18	94.2	66.7	84.0
HSI	0.898 (0.839-0.955)	≥ 34	0.641	92.7	71.4	3.24	0.10	89.9	78.1	86.3
ZJU index	0.903 (0.843-0.962)	≥ 37	0.688	91.7	77.1	4.01	0.11	91.7	77.1	87.0
FSI	0.912 (0.849-0.954)	≥ 15	0.688	91.7	74.3	4.01	0.11	91.7	77.1	87.8
TyG index	0.902 (0.839-0.966)	≥ 8.5	0.649	90.6	74.3	3.52	0.13	90.6	74.3	86.3
VAI	0.857 (0.774-0.937)	≥ 1.49	0.675	87.5	80.0	4.38	0.16	92.3	70.0	85.5

¹The optimal cut-off with the highest Youden index.

AUC: Area under the receiver operating characteristic curve; 95%CI: 95% confidence interval; FLI: Fatty liver index; HSI: Hepatic steatosis index; FSI: Framingham steatosis index; TyG: Triglycerides and glucose; VAI: Visceral adiposity index; SE: Sensitivity; SP: Specificity; PLR: Positive likelihood ratio; NLR: Negative likelihood ratio; PPV: Positive predictive value; NPV: Negative predictive value.