International Journal of Medicine Research

Authors
Punya Muralidhar, Rupal V Dosi

Abstract
Background and objectives There are limited tools to differentiate alcoholic liver disease (ALD) from non-alcoholic fatty liver disease (NAFLD). Liver biopsy despite being the gold standard is invasive while the easily available biochemical indices lack sensitivity and specificity. ANI (ALD/NAFLD Index) developed in 2006 by Dunn et al. proved to be an efficient yet non-invasive diagnostic tool to differentiate ALD from NAFLD. The aim of this study is to validate the efficiency of this index in the Indian population. Methods A Cross sectional observational study was carried out on a group of 48 inpatients of a tertiary care hospital in Vadodara, Gujarat out of which 24 patients were diagnosed with ALD and 24 with NAFLD. Case study forms were filled with relevant clinical history, examination results and investigations from their recent blood samples. Ultrasonography reports were accessed. Using this data the ANI score was calculated on an online calculator and appropriate statistical tests were applied. Results The value of ANI in ALD patients is significantly higher than that in NAFLD patients (Median of ALD= 9.2485 vs Median of NAFLD= -2.651) (P<0.001). The cut-off value for ANI was calculated to be >1.702, for which the index shows high sensitivity (95.83%) and specificity (83.33%). Interpretation and conclusions ANI scoring system proved to be an efficient diagnostic tool in the Indian population with a high sensitivity and specificity at the cut-off value of >1.702. Although it cannot replace liver biopsy as the gold standard, it has a better diagnostic performance compared to currently used serological markers like AST/ALT and MCV in differentiating ALD patients from NAFLD patients.