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In a study among people attending a check-up, an HSI below 30.0 ruled out fatty liver not caused by alcohol, with a sensitivity of 93.1%. An HSI above 36.0, on the other hand, may point to this kind of fatty liver.[1]
On this page, you can read what the Hepatic steatosis index is, what the guidelines say about a value that is too low or too high, what affects your value and which values are best to look at alongside it.
Also known as: hepatic steatosis index, HSI. At the lab: n/a.
The HSI is a calculated score, not a single measurement in your blood. The score comes from a study that looked for a simple measure of fatty liver not caused by alcohol.[1]
The formula is 8 times the ALT to AST ratio, plus your BMI. If you are a woman, 2 is added. If you have a condition affecting blood sugar regulation, 2 is added as well.[1]
In the study, the HSI had an area under the ROC curve of 0.812. This is a measure of how well the score separates participants with fatty liver from those without.[1]
The researchers wanted a simple measure to detect fatty liver not caused by alcohol. To do this, the HSI uses a few pieces of information: two liver values, your BMI, your sex and whether you have a condition affecting blood sugar regulation.[1]
Of the 2,692 participants with an HSI below 30.0 or above 36.0, 2,305 were classified correctly. That is 85.6%.[1]
According to the researchers, the HSI can help decide who should have an ultrasound of the liver, and whether changes to lifestyle are needed.[1]
| Value | Can point to | Who it is for |
|---|---|---|
| Below 30.0[1] | Rules out fatty liver not caused by alcohol, with a sensitivity of 93.1% | Check-up participants in the study |
| Between 30.0 and 36.0[1] | The study does not use these values to rule out or confirm fatty liver | Check-up participants in the study |
| Above 36.0[1] | May point to fatty liver not caused by alcohol, with a specificity of 92.4% | Check-up participants in the study |
Source: Lee et al., Dig Liver Dis 2010. Cut-off values from a study among people attending a check-up.[1]
In the study, an HSI above 36.0 indicated fatty liver not caused by alcohol, with a specificity of 92.4%. So a high value may point to fat in the liver. According to the researchers, that can be a reason for a liver ultrasound or for changes to your lifestyle.[1]
In the study, an HSI below 30.0 ruled out fatty liver not caused by alcohol, with a sensitivity of 93.1%. So a low value may suggest that this kind of fatty liver is not present.[1]
BioProfile is working on its own zones for each value, from risk to optimal. A doctor reviews those zones before they appear in your result.
In the study, a high ALT to AST ratio was a risk factor for fatty liver. In the formula, that ratio counts 8 times.[1]
In the study, a high BMI was also a risk factor. Your BMI is added directly to the score, so a higher BMI gives a higher HSI.[1]
If you are a woman, the formula adds 2.[1]
In the study, a condition affecting blood sugar regulation was a risk factor. If you have such a condition, the formula adds 2.[1]
The Hepatic steatosis index is part of BioProfile 77, 87, 121 and 150.[2]
The BioProfile editorial team wrote this page on 27 October 2026 from the sources below, which we read on 27 October 2026. Every number on this page comes from one of those sources, with that source's number next to it. An expert will still review this page; after that review, the expert's name and the date of the review will appear at the top. This page explains and does not diagnose. Discuss an abnormal value with your GP.
