NAFL screening score: A basic score identifying ultrasound-diagnosed nonalcoholic fatty liver
NAFL screening score: A basic score identifying ultrasound-diagnosed nonalcoholic fatty liver
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NAFL 筛查评分：识别超声诊断非酒精性脂肪肝的基本评分
DOI：
10.1016/j.cca.2017.09.020
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发表时间：
2017-12-01
影响因子：
5
通讯作者：
Zheng, Ming-Hua
中科院分区：
文献类型：
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作者：
Zhou, Yu-Jie;Zhou, Yi-Fan;Zheng, Ming-Hua
背景：目前已有多种非酒精性脂肪肝(NAFL)的非侵入性诊断评分方法，但其复杂性限制了临床应用。目的：开发和验证一种易于计算的非酒精性脂肪肝超声诊断评分系统。模型开发采用多变量Logistic回归模型。超声检查诊断NAFL。选择的变量被分配一个与Logistic回归分析估计的系数成比例的整数分数，即NAFL筛查分数(NSS)。通过分析受试者工作特征曲线(AUROC)下的面积来评估NSS识别NAFL的能力，并在独立的验证队列中进行测试。结果：NSS由年龄、体重指数(BMI)、甘油三酯(TG)、丙氨酸氨基转移酶(ALT/AST)、空腹血糖(FPG)、尿酸(UA)组成。与其他模型相比，NSS显示出相对较好的辨别能力(AUROC=0.825，验证队列中女性0.861)。最佳分界点为男性32分，女性29分。结论：我们开发并验证了NSS，一种易于使用的识别超声诊断NAFL的记分表。NSS对NAFL的早期诊断有一定的临床价值。
Background: Several non-invasive diagnostic scores for non-alcoholic fatty liver (NAFL) have been developed, but the clinical application is limited because of their complexity.Aim To develop and validate an easy-to-calculate scoring system to identify ultrasound-diagnosed NAFL.Methods: 48,489 patients from 2 centers were included in this study. Multivariable logistic regression models were employed for model development. Ultrasonography was applied to diagnose NAFL. The selected variables were assigned an integer score proportional to the estimated coefficient from the logistic regression analysis, namely NAFL Screening Score (NSS). The ability of the NSS to identify NAFL was assessed by analyzing the area under the receiver operating characteristic curve (AUROC) and was tested in an independent validation cohort. Additionally, the performance of NSS was compared with existing models.Results: NSS was developed as a basic score comprising of age, body mass index (BMI), triglyceride (TG), ALT/AST, fasting plasma glucose (FPG) and uric acid (UA) in both sexes. NSS showed a relatively good discriminative power (AUROC = 0.825 for males, 0.861 for females in the validation cohort) in comparison with other models. The optimal cut-off point was 32 for males and 29 for females.Conclusion: We developed and validated NSS, an easy-to-use score sheet identify ultrasound-diagnosed NAFL. NSS may be clinically useful for initial diagnosing NAFL.