## 3 Results  
A total of 215 patients who underwent FIB4, TE, and ARFI measurements were included retrospectively in the non-biopsy group. In this group, 66 cases were classified as NAFLD, 82 as CHB, and 67 as CHC. An additional group of 221 consecutive patients who underwent liver histology studieswere enrolled in the validation group. In this group, 125 cases were classified as NAFLD, 70 as CHB, and 26 as CHC (Figure 1). In the non-biopsy training group, more men were included than women (\(p<0.001\); Table 1a), particularly in the CHB subgroup. The CHB subgroup had the youngest mean age (\(53.38\pm 10.91\)), followed by the NBNC (\(57.10\pm 11.10\)) and CHC (\(62.48\pm 9.67\)) subgroups (statistical significance of differences can be summarized by the following formula: [(NBNC = CHB) \(\
eq\) CHC]). The body mass index (BMI) was higher in the NBNC subgroup than in the viral hepatitis subgroups [NBNC \(\
eq\) (CHB = CHC)]. The platelet count was lower in the CHC subgroup than in NBNC subgroup [NBNC \(\
eq\) CHC], while the AST and ALT levels were lower in the CHB subgroup than in the other two subgroups [CHB \(\
eq\) (NBNC = CHC)]. The estimated fibrosis score 4 was least frequent in the CHB subgroup (14.6%), followed by NBNC (24.2%), while it was the highest in the CHC (31.3%) subgroup (\(p=0.033\)). \begin{table}
\begin{tabular}{l l l l l}  & & \multicolumn{2}{c}{**(a)**} \\ \hline
**Total Cases** & **NBNC (N) 66** & **HBV (B) 82** & **HCV (C) 67** & **Multiple Comparisons** \\ \hline Male (\%) & 44 (66.7) & 76 (92.7) & 35 (52.2) & B \(\
eq\) (N = C) \\ Body mass index & 26.80 \(\pm\) 4.60 & 24.89 \(\pm\) 3.34 & 24.81 \(\pm\) 3.83 & N \(\
eq\) (B = C) \\ Age (year) & 57.10 \(\pm\) 11.10 & 53.38 \(\pm\) 10.91 & 62.48 \(\pm\) 9.67 & (N = B) \(\
eq\) C \\ AST (IU/L) & 51.53 \(\pm\) 49.51 & 35.05 \(\pm\) 13.29 & 56.12 \(\pm\) 30.66 & B \(\
eq\) (N = C) \\ ALT (IU/L) & 52.35 \(\pm\) 38.47 & 35.54\(\pm\) 19.05 & 61.88 \(\pm\) 39.80 & B \(\
eq\) (N = C) \\ Platelets (10\({}^{9}\)/L) & 203.3\(\pm\) 76.91 & 179.9 \(\pm\) 67.77 & 164.06 \(\pm\) 60.04 & N \(\
eq\) C \\ Spleen index & 18.77 \(\pm\) 8.77 & 18.98 \(\pm\) 10.36 & 17.61 \(\pm\) 8.19 & NS \\ Estimated fibrosis score * & & & & \\
4 (\%) & 16 (24.2) & 12 (14.6) & 21 (31.3) & B \(\
eq\) (N = C) \\
3 (\%) & 8 (121.1) & 11 (13.4) & 14 (20.9) & \(P\) = 0.033 \\
2 (\%) & 5 (7.6) & 12 (14.6) & 2 (3.0) & \\ \(\leq\)1 (\%) & 37 (56.1) & 47 (57.3) & 30 (44.8) & \\ \hline \end{tabular}  
* Cutoff values of meanARFI (m/sec) for fibrosis scores 1-4 in different etiologies: NBNC (1.79,1.32,1.25); CHB (1.46,1.32,1.22); CHC (1.71,1.37,1.23)  
\end{table} 
Table 1: (a) Demography of patients without liver histology study; (b) Demography of patients received liver histology study. Figure 1: Flow chart of study patients. In the biopsy group, hepatocellular carcinoma (HCC) was more frequent among the chronic hepatitis subgroups than the NAFLD subgroup ([NAFLD \(\
eq\) (HCB = CHC)]; Table 1b). The mean age was younger in NAFLD (\(49.85\pm 13.43\) years) than CHC (\(57.91\pm 8.35\) years, \(p=0.007\)). ALT levels were elevated in the NAFLD subgroup compared to the other two subgroups [NAFLD \(\
eq\) (CHB = CHC)]. The platelet count was higher, and the prothrombin time (INR) was lower, in the NAFLD subgroup than in the viral hepatitis subgroups [NAFLD \(\
eq\) (CHB = CHC)]. Lower fibrosis grades with higher fat cell fractions were noted in the NAFLD subgroup than in the viral hepatitis subgroups [NAFLD \(\
eq\) (CHB = CHC)]. Sixteen-one (\(48.8\%\)) patients in the NAFLD subgroup had fat cell fractions greater than \(66\%\), compared to only \(15.4\%\) and \(15.7\%\) of patients in the CHB and CHC subgroups, respectively. Liver stiffness was successfully measured by TE and ARFI in all study patients. However, 5 patients with ARFI measurement interquartile ranges (IQR)/median values greater than \(15\%\) and two with TE measurement IQR/median values greater than \(30\%\) were excluded from this study.