A prospective, cross-sectional, pilot study indicated that in patients with a clinical diagnosis of non-alcoholic fatty liver disease (NAFLD), NAFLD individual fibrosis index (NIFI) appears to be beneficial to predict advanced NAFLD fibrosis and potentially assist in avoiding unnecessary interventions such as liver biopsy in low-risk patients.

Atul Goyale et al. undertook this study to examine the association between serum-based markers (including adipokines and cytokines) with NAFLD severity. The study incorporated 105 adult patients (61 men, mean age 53.5 years) with varying severity of NAFLD. Notably, 12 serum-based markers were estimated by three biochip platforms and two enzyme-linked immunosorbent assay (ELISA) methods.

Furthermore, NIFI was developed with the aid of serum-based markers mostly correlated with the severity of  fibrosis. Raised levels of interleukin-6 and reduced serum levels of matrix metalloproteinase-9 were linked with higher fibrosis as estimated by fibroscan in the multivariable regression assessment.

Thus, increasing fibrosis severity in NAFLD is associated with differential expression of interleukin-6 and matrix metalloproteinase-9. Utilizing receiver-operating characteristic curve assessment for the NIFI, the area under the curve to forecast fibroscan values ≥ 7.2 kPa was 0.77, with a sensitivity of 89.3%, specificity of 57.9%, and a positive likelihood ratio of 2.8.