Abstract
Background: There is a need to identify cost-effective, simple, non-invasive diagnostic tools for Non Alcoholic Fatty Liver Disease (NAFLD), in high risk communities, as an alternative to the invasive and costly methods. The objectives of this study were to study the prevalence of NAFLD using ultrasound among female students in Hail, Saudi Arabia and using these results to validate different simple non-invasive indices. Methods: A total of 568 females, 20-30 years of age, were enrolled. Ultrasound tests were performed to identify different grades of NAFLD. An age-matched case (NAFLD) and control (healthy) groups (105 participants, each), according to the ultrasound results, were compared to identify risk factors for NAFLD. Regression models were used to examine the associations between NAFLD and potential risk factors. Validation of different non-invasive indices against ultrasound results were conducted using Receiver Operating Characteristic (ROC) Curve cut offs. Results: The prevalence of mild NAFLD was 15.5% and moderate NAFLD was 4.9%, while no severe NAFLD cases were observed. The percentage of participants in the case group who had body mass index (BMI) >= 30, impaired fasting glucose, aspartate aminotransferase over alanine aminotransferase, [AST/ALT] >= 0.8, was higher (p <0.001) than that of the control group. AFLD fibrosis score showed the highest sensitivity (96%) for the diagnosis of NAFLD, while the highest specificity was for the HAIR score (89.7%). Conclusions: Prevalence of NAFLD among young females in Hail was high. NAFLD fibrosis score showed the highest accuracy among the non-invasive methods in the diagnosis of NAFLD.