What is hepatic steatosis?
Hepatic steatosis, sometimes called "fatty liver disease," is an excessive buildup of fat in liver cells. It is now strongly associated with metabolic syndrome: overweight or obesity, type 2 diabetes, high blood pressure, and lipid panel abnormalities are all very common in people affected by it.
Why it's often silent
Hepatic steatosis usually causes no symptoms at an early stage. It is most often discovered incidentally, during a routine blood test or an abdominal ultrasound done for another reason. It is precisely because it is silent that a simple screening tool like the FLI is useful: it helps identify people for whom an imaging exam is most likely to be worthwhile.
How the FLI works
The FLI combines 4 pieces of information that are easy to obtain: BMI, waist circumference, and 2 blood test results (triglycerides and GGT). It produces a score from 0 to 100. A low score makes a fatty liver unlikely; a high score makes it likely, without formally confirming it — that's where an ultrasound comes in, the only exam able to directly visualize fat in the liver.
After a high result? The question of fibrosis
A fatty liver on its own is most often benign and reversible with lifestyle changes. The real risk appears when the associated inflammation leads, over time, to fibrosis: a progressive buildup of scar tissue. This is a separate question from "do I have a fatty liver?", for which another validated score exists, the FIB-4 — offered at the end of this test if your result suggests it.
The limits of this score
The FLI is a screening tool, not a diagnostic one: it estimates a likelihood, not a certainty. Like any score built on population data, it can be wrong at the individual level — a result in the intermediate or high zone deserves a conversation with a doctor rather than being interpreted on its own.
