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Fatty liver index (FLI): more than a marker of hepatic steatosis

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Abstract

Fatty liver index (FLI) was developed as a simple and accurate marker of hepatic steatosis. FLI is derived from an algorithm based on body mass index, waist circumference, and levels of triglycerides and gamma-glutamyltransferase, and it is widely used in clinical and epidemiological studies as a screening tool for discriminating between healthy and nonalcoholic fatty liver disease (NAFLD) subjects. However, a systematic review of the literature regarding FLI revealed that this index has more extensive relationships with biochemical and physiological parameters. FLI is associated with key parameters of lipid, protein and carbohydrate metabolism, hormones, vitamins and markers of inflammation, or oxidative stress. FLI can be a predictor or risk factor for a number of metabolic and nonmetabolic diseases and mortality. FLI is also used as an indicator for determining the effects of health-related prevention interventions, medications, and toxic substances on humans. Although in most cases, the exact mechanisms underlying these associations have not been fully elucidated, they are most often assumed to be mediated by insulin resistance, inflammation, and oxidative stress. Thus, FLI may be a promising marker of metabolic health due to its multiple associations with parameters of physiological and pathological processes. In this context, the present review summarizes the data from currently available literature on the associations between FLI and biochemical variables and physiological functions. We believe that this review will be of interest to researchers working in this area and can provide new perspectives and directions for future studies on FLI.

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Funding

The study was conducted within the framework of the research work of the Institute of Physiology of Кomi Science Centre of the Ural Branch of the Russian Academy of Sciences, FRC Komi SC UB RAS, FUUU-2022-0063 (No 1021051201877-3).

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  1. Institute of Physiology of Кomi Science Centre of the Ural Branch of the Russian Academy of Sciences, FRC Komi SC UB RAS, 50 Pervomayskaya str., 167982, Syktyvkar, Russia

    Anastasiya M. Kaneva & Evgeny R. Bojko

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  1. Anastasiya M. Kaneva
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AMK: conceptualization, planned and designed the review structure, literature survey, wrote the first draft of the manuscript, writing—review and editing; ERB: editing and overall revision, suggestions, supervision; The authors declare that all data were generated in-house and that no paper mill was used.

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Key points

• Fatty liver index has been developed as a marker of hepatic steatosis.

• Fatty liver index is also associated with other metabolic and nonmetabolic diseases.

• Fatty liver index has extensive links with biochemical and physiological parameters.

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Kaneva, A.M., Bojko, E.R. Fatty liver index (FLI): more than a marker of hepatic steatosis. J Physiol Biochem 80, 11–26 (2024). https://doi.org/10.1007/s13105-023-00991-z

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