Non-laboratory-based self-assessment screening score for non-alcoholic fatty liver disease: development, validation and comparison with other scores.
Non-laboratory-based self-assessment screening score for non-alcoholic fatty liver disease: development, validation and comparison with other scores.
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DOI：
10.1371/journal.pone.0107584
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Kim DJ
中科院分区：
文献类型：
--
作者：
Lee YH;Bang H;Park YM;Bae JC;Lee BW;Kang ES;Cha BS;Lee HC;Balkau B;Lee WY;Kim DJ
非酒精性脂肪肝（NAFLD）是一种在全球范围内流行且迅速增加的疾病;然而，目前还没有广泛接受的筛查模型来评估NAFLD的风险。因此，我们的目的是使用两个独立的队列在一般人群中开发和验证NAFLD的自我评估评分。开发队列包括2008-2010年在韩国国家健康保险服务Ilsan医院就诊的15676例受试者（8313例男性和7363例女性）。在定期健康检查和腹部超声诊断脂肪肝期间检查人体测量、临床和实验室数据。进行逻辑回归分析以确定流行NAFLD的预测因子并推导风险评分/模型。我们验证了我们的模型，并使用外部队列（N = 66868）与其他现有方法进行了比较。 简单的自我评估评分包括年龄、性别、腰围、体重指数、糖尿病和血脂异常史、酒精摄入、体力活动和绝经状态，这些都与NAFLD独立相关，数值为0-15。≥8的临界点定义为58%的男性和36%的女性处于NAFLD的高风险中，并且在男性中产生80%的灵敏度（在女性中为77%），特异性为67%（81%），阳性预测值为72%（63%），阴性预测值为76%（89%）和AUC为0.82（0.88）。使用验证数据集获得了可比结果。综合NAFLD评分（包括其他实验室参数）具有增强的辨别能力，男性AUC为0.86，女性为0.91。在具有较高脂肪肝等级或肝脏疾病严重程度（例如，单纯性脂肪变性、脂肪性肝炎）。新的非实验室自我评估评分可能有助于识别NAFLD高风险个体。进一步的研究是必要的，以评估在各种设置的分数的效用和可行性。
Non-alcoholic fatty liver disease (NAFLD) is a prevalent and rapidly increasing disease worldwide; however, no widely accepted screening models to assess the risk of NAFLD are available. Therefore, we aimed to develop and validate a self-assessment score for NAFLD in the general population using two independent cohorts. The development cohort comprised 15676 subjects (8313 males and 7363 females) who visited the National Health Insurance Service Ilsan Hospital in Korea in 2008–2010. Anthropometric, clinical, and laboratory data were examined during regular health check-ups and fatty liver diagnosed by abdominal ultrasound. Logistic regression analysis was conducted to determine predictors of prevalent NAFLD and to derive risk scores/models. We validated our models and compared them with other existing methods using an external cohort (N = 66868). The simple self-assessment score consists of age, sex, waist circumference, body mass index, history of diabetes and dyslipidemia, alcohol intake, physical activity and menopause status, which are independently associated with NAFLD, and has a value of 0–15. A cut-off point of ≥8 defined 58% of males and 36% of females as being at high-risk of NAFLD, and yielded a sensitivity of 80% in men (77% in women), a specificity of 67% (81%), a positive predictive value of 72% (63%), a negative predictive value of 76% (89%) and an AUC of 0.82 (0.88). Comparable results were obtained using the validation dataset. The comprehensive NAFLD score, which includes additional laboratory parameters, has enhanced discrimination ability, with an AUC of 0.86 for males and 0.91 for females. Both simple and comprehensive NAFLD scores were significantly increased in subjects with higher fatty liver grades or severity of liver conditions (e.g., simple steatosis, steatohepatitis). The new non–laboratory-based self-assessment score may be useful for identifying individuals at high-risk of NAFLD. Further studies are warranted to evaluate the utility and feasibility of the scores in various settings.
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