Validation of the Fatty Liver Index for Nonalcoholic Fatty Liver Disease in Middle-Aged and Elderly Chinese.
Validation of the Fatty Liver Index for Nonalcoholic Fatty Liver Disease in Middle-Aged and Elderly Chinese.
复制标题
中国中老年人非酒精性脂肪肝脂肪肝指数的验证。
DOI：
10.1097/md.0000000000001682
复制
发表时间：
2015-10
期刊：
影响因子：
1.6
通讯作者：
Ning G
中科院分区：
文献类型：
--
作者：
Huang X;Xu M;Chen Y;Peng K;Huang Y;Wang P;Ding L;Lin L;Xu Y;Chen Y;Lu J;Wang W;Bi Y;Ning G
脂肪肝指数（FLI）是一种基于腰围、体重指数（BMI）、甘油三酯和γ-谷氨酰转移酶（GGT）的算法，最初在西方国家开发用于检测脂肪肝。本研究旨在评价FLI预测中老年人非酒精性脂肪性肝病（NAFLD）的准确性和最佳截断点。这项横断面研究包括8626名40岁或以上的中国成年人从嘉定区，中国上海招募。通过标准方案收集人体测量和生化特征。肝脏超声诊断为NAFLD。分别采用受试者工作特征曲线下面积（AUROC）和最大约登指数分析评价FLI检测NAFLD的准确性和临界点。FLI对NAFLD的AUROC为0.834（95%置信区间：0.825-0.842），大于其各组分的平均值[0.786腰围、BMI、甘油三酯和GGT分别为0.776 -0.796、0.783（0.773-0.793）、0.727（0.716-0.739）和0.707（0.695-0.719）]（均P < 0.001）。FLI诊断NAFLD的最佳临界值为30，最大约登指数为0.51，敏感性为79.89%，特异性为71.51%。FLI诊断的NAFLD患者的腰围、BMI、血压、血脂、转氨酶等代谢指标均低于超声诊断的NAFLD患者（P均<0.05）。 FLI能准确诊断NAFLD，在中老年人群中以30分为最佳分界点。FLI诊断的NAFLD患者代谢较差，应重视NAFLD的代谢控制和管理。
The fatty liver index (FLI), which is an algorithm based on waist circumference, body mass index (BMI), triglyceride, and gamma-glutamyl-transferase (GGT), was initially developed to detect fatty liver in Western countries. Our study aimed to evaluate the accuracy and optimal cut-off point of the FLI for predicting nonalcoholic fatty liver disease (NAFLD) in middle-aged and elderly Chinese. This cross-sectional study included 8626 Chinese adults aged 40 years or above recruited from Jiading District, Shanghai, China. Anthropometric and biochemical features were collected by a standard protocol. NAFLD was diagnosed by hepatic ultrasonography. The accuracy and cut-off point of the FLI to detect NAFLD were evaluated by area under the receiver operator characteristic curve (AUROC) and the maximum Youden index analysis, respectively. The AUROC of the FLI for NAFLD was 0.834 (95% confidence interval: 0.825–0.842), and larger than that of its each individual component [0.786 (0.776–0.796), 0.783 (0.773–0.793), 0.727 (0.716–0.739), and 0.707 (0.695–0.719) for waist circumference, BMI, triglyceride, and GGT, respectively] (all P < 0.001). The optimal cut-off point of the FLI for diagnosing NAFLD was 30 with the maximum Youden Index of 0.51, achieving a high sensitivity of 79.89% and a specificity of 71.51%. The FLI-diagnosed NAFLD individuals were in worse metabolic characteristics (waist circumference, BMI, blood pressure, serum lipids, and aminotransferases) than ultrasonography-diagnosed NAFLD patients (all P < 0.05). The FLI could accurately identify NAFLD and the optimal cut-off point was 30 in middle-aged and elderly Chinese. As FLI-diagnosed NAFLD patients were in worse metabolism, much attention should be paid to the metabolic controls and managements of NAFLD.