Objectives Early screening of non-alcoholic fatty liver disease (NAFLD) is critical for early diagnosis and management. The disease was renamed and its diagnostic criteria revised as metabolic-associated FLD (MAFLD) in 2020 and further updated to metabolic dysfunction-associated steatotic liver disease (MASLD) in 2023.
This study evaluated the predictive performance and clinical feasibility of non-invasive diagnostic indicators across the NAFLD, MAFLD and MASLD diagnostic criteria. Design Cross-sectional study.
Setting Health Management Centre in China. Participants A total of 5810 participants aged ≥18 years were enrolled.
Individuals with missing laboratory data, imaging results or self-reported information were excluded. Primary and secondary outcome measures Disease-specific indicators included Fatty Liver Index (FLI), Hepatic Steatosis Index and Zhejiang University index (ZJU).
Non-disease-specific indicators included lipid accumulation product (LAP), Visceral Adiposity Index and the Triglyceride and Glucose Index. Subgroup analysis was performed by gender and Body Mass Index (BMI).
Results The area under the receiver operating characteristic curve (AUROC) for all six non-invasive indicators exceeded 0.7.
Overweight/obese subgroups favored FLI or ZJU depending on criterion and comparison.