NAFLD diagnosis criteria

Sonographic diagnosis of fatty liver, defined as diffusely increased liver echogenicity (>right renal parenchyma) with vascular blurring;

A negative history of alcohol consumption female > 14 units (U)/week, male > 21 U/week (1 U = 10 g alcohol); and: Exclusion of liver disease of other etiology including drug-induced, autoimmune, viral hepatitis, cholestatic, metabolic, and genetic liver disease. If the 3rd criterion cannot be rolled out it is considered as suspected for NAFLD for purpose of analysis.

ALD diagnosis criteria

The same as NAFLD, but with excessive alcohol consumption.

Abnormalities in LFTs

Deviations of LFT (ALT, AST, AP, GGT) and STB values were determined in relation to the value of ULN for each study site. The increase of at least one unit from ULN taking with reference values for each site was defined as “deviation”. For ALT and AST, the deviation up to one ULN, 1 - 5 ULN have been calculated. For AP, GGT and STB, elevation by 1.5, 1.5 - 2; >2 fold from ULN have been calculated.

IHC based on the EASL criteria

Elevated AP levels higher than 1.5 ULN and GGT levels > 3 ULN with or without clinically present symptoms or signs with excluded extrahepatic cholestasis at least via abdominal US.

IHC based on the simplified criteria

Any elevation of AP and GGT; with or without elevation of STB; with or without clinically present symptoms or signs with excluded extrahepatic cholestasis at least via abdominal US.

MetS diagnosis criteria

Central (abdominal) obesity with waist circumference > 94 cm in men and >80 cm in women, plus any two of the following additional criteria:

Arterial hypertension

Blood pressure (BP) ≥ 130/85 mmHg

Raised triglycerides

≥1.7 mmol/L

Reduced high-density lipoprotein (HDL)—cholesterol

<1.0 mmol/L in men; <1.2 mmol/L in women

Raised low-density

lipoprotein (LDL)—cholesterol

≥3.0 mmol/L

Raised fasting plasma glucose (FPG)

≥6.1 mmol/L

Glucose intolerance

2-h plasma glucose during an oral glucose tolerance test is ≥7.8 but ≤11.1 mmol/L

Pathology according to liver ultrasound

This was established if at least one of the following was present: increased echogenicity, steatosis or diffuse changes of the liver.