identify 92% of the patients as being without advanced fibrosis. Of the
129 patients with advanced fibrosis, 26 patients (20.2%) were wrongly
classified by the NFS. Analysing the utility of the NFS in subgroups stratified
byDM, 14.4% (19/132) ofDMpatientswithout advanced fibrosis as
opposed to 3.5% (7/202) of non-DM patients without advanced fibrosis
were wrongly predicted as the high risk NFS category. Of the DM patients
with advanced fibrosis 10.1% (9/89) were inaccurately predicted
as the low risk NFS category, while 42.5% (17/40) of the non-DM patients
with advanced fibrosis were inaccurately predicted as the low
risk NFS category. Spearman's correlation analysis of the individual
components of NFS to advanced fibrosis in both the patients with and
without DM was performed [Table 5]. This showed that in relation
to advanced fibrosis, the correlation coefficients of the individual
components used to calculate NFS were correspondingly lower in the
non-DM patients compared to the DM patients. Other fibrosis scores
developed for NAFLD, namely the BARD score and AST to ALT ratio
were also tested in our cohort for their utility in patients with and
without DM [Table 6]. Similar to our findings with the NFS, there were
discrepancies in the utility of the BARD score and AST to ALT ratio
between patients with and without DM.