Supplementary Material for: Comparisons of insulin resistance- and steatosis-based scores in monitoring metabolic associated fatty liver disease treatment response

Background: Quantitative measurements of liver fat contents (LFCs) by magnetic resonance imaging derived-proton density fat fraction (MRI-PDFF) are accurate but limited by availability, convenience, and expense in the surveillance of metabolic associated fatty liver (MAFLD). Insulin resistance (IR) and steatosis-associated serum indices are useful in screening for MAFLD, but their value in monitoring MAFLD with or without chronic hepatitis B virus (CHB) infection remains unclear and we aimed to evaluate these scores in predicting changes in LFC. Methods: We conducted a prospective study between January, 2015 and December, 2021 with 620 consecutive participants with MAFLD (212 participants with CHB) who received a 24-week lifestyle intervention. The homeostasis model assessment of insulin resistance (HOMA-IR), HOMA2 index, Glucose insulin ratio, Quantitative Insulin Sensitivity Check Index, Fasting Insulin Resistance Index, Fatty liver index (FLI), Hepatic steatosis index (HSI), Liver fat score (LFS), Visceral Adiposity Index, and Triglycerides * Glucose were calculated. Results: When using endpoints such as LFS improvements of ≥5% or 10% or escalations of ≥5%, LFS had the highest area under the curve (AUC) values at all endpoints for MAFLD alone (0.756, 95% CI: 0.707–0.805; 0.761, 95% CI: 0.705–0.818; 0.807, 95% CI: 0.713–0.901, all P