Hepaxa® Fatty Liver Index

A validated tool for predicting steatosis in NAFLD patients.1

Diagnosing NAFLD patients can be challenging especially when there is limited to no access to the most accurate diagnostic technology or the patient has limited financial resources. Using a single metric (such as liver enzyme scores) can be a relatively inconsistent means of assessing the patient’s epidemiology or predicting their fatty liver disease progression. One remarkably accurate tool is the Fatty Liver Index (FLI) method.  The improved value of this diagnostic approach stems from the use of four metrics rather than just one.  By using the FLI, a patient’s likelihood for steatosis becomes reliable at a rate above 90%.

Many Fatty Liver Index (FLI) calculators are available online at no cost.  We recommend using the one below:

The four metrics included in the FLI calculation are:1,2

Body Mass Index


Liver Enzyme Score

Triglyceride Level

Using the FLI Results1,2

The Fatty Liver Index (FLI) is a validated index to help you assess the NAFLD patient’s steatosis status. It is a predictive tool that will help identify those patients who need to have a more formal diagnostic test run – such as a Fibroscan, ultrasound or MRI. An FLI score above 60 traditionally indicates the presence of steatosis.  Likewise, the FLI score below 30 traditionally indicates that no steatosis is expected. The grey area is the score range from 30 to 60.  However, in a recent clinical trial (called CONDIN), it was determined through Post Hoc analysis that any FLI score of 40 or above would be an excellent indication that the NAFLD patient would respond well to Hepaxa®.  In the study, the FLI>40 patients who took Hepaxa for 6 months experienced a significant reduction in liver fat and a significant reduction in liver enzyme scores.

Fatty Liver Index Scale1,2

FLI Worksheet

Download and print copies of this worksheet to chart your own patients fatty liver disease /FLI scores.  Better yet, check them again in six-month intervals to determine their progression/regression with respect to the probability of steatosis.

FLI Examples1

It can be difficult to predict which patients actually have NAFLD and/or actually have steatosis. Here are two examples that illustrate that very point and reinforce the concept that you cannot predict steatosis by way of a single metric such as BMI or liver enzyme scores alone. The FLI tool will help you to better identify steatosis (NAFLD) and allow you to manage your patient accordingly.

FLI Example

Male Patient Profile

FLI Example

Female Patient Profile

FLI Validation1,3

Using four metrics rather than one has created a valuable tool in the FLI.  The FLI was introduced in a 2006 study by Bedogni and established credibility for the FLI approach. Since the introduction of the FLI, it has been adopted as a surrogate marker of hepatic steatosis, has been applied in numerous prospective, epidemiological studies and can predict the risk of incident T2DM, the incidence of atherosclerosis and cardiovascular disease and of hepatic-related mortality.

1 Bedogni, G. et.al., BMC Gastroenterology; 2006, 6:33
2 Data on file, BASF, AS.
3 Cuthbertson, DJ, et.al.; Euro Jour of Endocrinology, 171:5, 561-569