Abstract: Objective The aim of this study was to investigate diagnostic performance of Fibroscan in evaluating hepatic steatosis in patients with non alcoholic fatty liver diseases (NAFLD). Methods A total of 115 patients with NAFLD were encountered in our hospital between July 2022 and December 2024, and all underwent liver biopsies and Fibroscan for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). Serum cytokeratin 18 M30 fragment (CK 18-M30) level were detected by ELISA. Receiver operating characteristic curve (ROC) was applied to assess diagnostic efficacy. Results Of the 115 patients with NAFLD in our series, liver pathological examination found hepatic steatosis S0 in 5 cases, S1 in 21 cases, S2 in 46 cases and S3 in 43 cases; serum CK 18-M30 level in S3 group was (145.6±27.3)U/L, much higher than [(123.7±25.2)U/L, P＜0.05] in S 2 group or [(100.1±24.5)U/L, P＜0.05] in S0-S1 group; serum total cholesterol, triglycerides and low-density lipoprotein levels in patients with S3 were much higher, while high-density lipoprotein level was much lower than in patients with S0-S1 or S2 group(P＜0.05); CAP and LSM in S3 group were (332.8±30.1)dB/m and (8.5±1.3)kPa, significantly higher than [(298.9±31.5)dB/m and (6.8±1.4)kPa, respectively, P＜0.05] in S2 group or [(252.1±9.7)dB/m and (5.7±0.9)kPa, respectively, P＜0.05] in S0-S1 group; the AUC was 0.890, with sensitivity (Se) of 84% and specificity (Sp) of 74%, when CAP was applied to evaluate equal to or greater than S2 liver steatosis, much superior to serum CK 18-M30 did (the AUC was 0.620, Se of 78% and Sp of 46%). Conclusion The CAP obtained by Fibroscan scan could accurately stratify liver steatosis in patients with NAFLD, and merits further clinical verification.

Key words: Nonalcoholic fatty liver disease, Liver steatosis, Controlled attenuation parameters, Diagnosis