الفهرس 
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Abstract
”Introduction: Non-alcoholic fatty liver disease has become the most common chronic liver disease with an estimated global prevalence of 25% of adults. Because NAFLD is largely asymptomatic, and because optimal timing of treatment depends on accurate staging of fibrosis risk, screening at the primary care level is critical, together with consistent, timely, evidence-based, widely accessible, and testable management processes. The Aim of this study: To initially stratify the risk of liver cirrhosis in patients with first diagnosed NAFLD via non-invasive and available modalities including abdominal ultrasound, APRI score, FIB-4 score, NFS, HSI, and BARD score. Patients and methods: Our prospective cross-sectional study included 81 patients with newly diagnosed NAFLD in Hepatology and Gastroenterology Unit, Specialized Medical Hospital, Mansoura University from March 2022 to March 2023 after approval by IRB, Faculty of Medicine, and Mansoura University. Results: 1- By NAFLD fibrosis score, the majority of our cases were unlikely to develop liver fibrosis 55.6%, 30.9% were indeterminate and only 13.6% were most likely to develop liver fibrosis. While, by FIB-4, the majority of cases were low risk (76.5%) and the high-risk patients were only 7 (8.6%). 2- 65.4% were diabetic. The diabetic cases were 24 (45.3%), 20 (37.7%), and 9 (17.0%) in the unlikely, indeterminate and the most likely to develop liver fibrosis respectively regarding NAFLD fibrosis score. There was significant association between NFS and DM. 3- No significant association between NFS and liver & kidney function tests and lipid profile. 4- There was significant association between NFS and both coarse liver and degree of steatosis, 34.6% had pre-cirrhotic changes and 43.2% had severe steatosis. The coarse liver cases in the unlikely, indeterminate and the most likely group to develop liver fibrosis were 3.6%, 57.1%, and 39.3%, respectively. 5- Concerning categorization of FIB4, APRI, BARD, hepatic steatosis indices and degree of steatosis by abdominal ultrasound via NFS, the median APRI in the unlikely, indeterminate and most likely to develop liver fibrosis were 0.165, 0.27, and 0.41, there were significant difference in APRI score in the three groups. 6- There were significant correlation between NFS and both FIB4 and APRI. 7- ROC curve analysis for APRI score as a predictor of severe fibrosis revealed that the APRI score had an AUC of 0.832 (CI: 0.74-0.93). The ROC analysis demonstrated that the APRI score was indeed able to predict severe fibrosis satisfactorily (AUC = 0.832, Cutoff >0.26, sensitivity=90.9%, specificity=64.3% and accuracy=67.9%). Conclusion: The NAFLD fibrosis score, FIB-4 and APRI scores appears to be reliable non-invasive tools to determine the severity of liver fibrosis in NAFLD patients. However, BARD scores and hepatic steatosis indices do not correlate with imaging evidence of fibrosis like NAFLD and APRI scores. Keywords: APRI, BARD, FIB-4, NAFLD.”