Correlation of Demography, Liver Function Tests, and Lipid Profile with Fibroscan Results in Patients with Nonalcoholic Fatty Liver Disease Attending a Tertiary Care Hospital in West Bengal

Abstract

Introduction: Nonalcoholic fatty liver disease (NAFLD) is a prevalent cause of chronic liver disease that can progress to nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. Early detection of advanced fibrosis is crucial in preventing disease progression. Although liver biopsy is considered the gold standard, its limitations necessitate reliable, non-invasive alternatives such as transient elastography (FibroScan) and serum-based scoring systems. Aims and Objectives: This study aims to evaluate the correlation of demographic parameters, liver function tests, and lipid profiles with FibroScan-based fibrosis stages in NAFLD patients, as well as to compare the diagnostic performance of the aspartate aminotransferase to platelet ratio index (APRI), FIB-4, the BARD score, and the AST/ALT ratio. Materials and Methods: This observational cross-sectional study enrolled 497 NAFLD patients (271 males and 226 females) at a tertiary care hospital in West Bengal from January 2020 to December 2024. Exclusion criteria included alcohol intake, viral hepatitis, autoimmune hepatitis, drug-induced liver injury, and other metabolic liver diseases. Fibrosis stages (F0–F4) were determined by FibroScan. APRI, FIB-4, and BARD scores were calculated, and statistical analysis included Pearson’s correlation, regression, and receiver operating characteristic (ROC) curve analysis. Results: Most patients were in the early stages—F0 (33.8%), F1 (30.6%), and F2 (23.4%). Age indicated a weak positive correlation with fibrosis stage (r = 0.111, p = 0.0135). APRI and FIB-4 demonstrated moderate diagnostic accuracy (Area under the curve [AUC] = 0.66 each) with high specificity but moderate sensitivity. The BARD score demonstrated lower discrimination (AUC = 0.58) but performed better in cirrhosis. The AST/ALT ratio demonstrated poor diagnostic performance (AUC = 0.53). Females exhibited significantly higher BARD scores and AST/ALT ratios. Conclusion: APRI and FIB-4 are moderately effective, low-cost diagnostic tools for advanced fibrosis in NAFLD, but their low sensitivity limits their use as standalone diagnostic tests. Combining non-invasive scores with FibroScan enhances staging accuracy, especially in resource-limited settings. Early integration of such combined approaches may help reduce disease progression and improve patient outcomes.