Park Young Jin, Lim Jie Hyang, Kwon Eun Ryoung, Kim Hee Kyoung, Jung Myoung Chul, Seol Kyoung Hwan, Noh Woo Yong, Kim Na Eun
Department of Family Medicine, Busan Medical Center, Busan, Korea.
Korean J Hepatol. 2011 Mar;17(1):19-26. doi: 10.3350/kjhep.2011.17.1.19.
BACKGROUND/AIMS: Abdominal ultrasonography is useful for the detection and diagnosis of nonalcoholic fatty liver disease (NAFLD). The aims of this study were to establish a predictive model for the selection of subjects for abdominal ultrasonography for the diagnosis of NAFLD and to assess validity of the model.
The subjects included 901 people who visited the health examination center of the Busan Medical Center. We conducted multiple logistic regression analyses of potential risk factors to identify independent risk factors for NAFLD, and developed an index system.
Four independent risk factors were identified. The index system was developed by assigning 1 clinical scoring point to approximately 0.7 logistic regression coefficients to each factor as follows: alanine aminotransferase/aspartate aminotransferase ratio >1.5 (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.21-4.07; P=0.010), 1 point; γ-glutamyl transpeptidase >50 (OR, 2.15; 95% CI, 1.13-4.07; P=0.019), 1 point; triglyceride >150 mg/dL (OR, 1.92; 95% CI, 1.14-3.24; P=0.015), 1 point; 23 kg/m(2)≤BMI⟨25 kg/m(2) (OR, 3.68; 95% CI, 2.05-6.63; P<0.001), 2 points; and BMI 25 kg/m(2) (OR, 7.65; 95% CI, 4.29-13.62; P<0.001), 3 points. The area under the receiver operating characteristics curve was 0.797 (95% CI, 0.751-0.842), and when 3 points was used as a cut-off value, the sensitivity and specificity were 71.7% and 75.9%, respectively.
NAFLD can be predicted through the clinical application of the index system established herein. If abdominal ultrasonography is used for high-risk patients, NAFLD will be diagnosed and managed in its early stage.
背景/目的：腹部超声检查对于非酒精性脂肪性肝病（NAFLD）的检测和诊断很有用。本研究的目的是建立一个预测模型，用于选择接受腹部超声检查以诊断NAFLD的受试者，并评估该模型的有效性。
研究对象包括901名到釜山医疗中心健康检查中心就诊的人。我们对潜在危险因素进行了多项逻辑回归分析，以确定NAFLD的独立危险因素，并建立了一个指标体系。
确定了四个独立危险因素。通过为每个因素分配约0.7的逻辑回归系数1个临床评分点来建立指标体系，如下：丙氨酸氨基转移酶/天冬氨酸氨基转移酶比值>1.5（比值比[OR]，2.22；95%置信区间[CI]，1.21 - 4.07；P = 0.010），1分；γ-谷氨酰转肽酶>50（OR，2.15；95% CI，1.13 - 4.07；P = 0.019），1分；甘油三酯>150 mg/dL（OR，1.92；95% CI，1.14 - 3.24；P = 0.015），1分；23 kg/m²≤体重指数（BMI）<25 kg/m²（OR，3.68；95% CI，2.05 - 6.63；P < 0.001），2分；BMI≥25 kg/m²（OR，7.65；95% CI，4.29 - 13.62；P < 0.001），3分。受试者工作特征曲线下面积为0.797（95% CI，0.751 - 0.842），当以3分为截断值时，灵敏度和特异度分别为71.7%和75.9%。
通过本文建立的指标体系的临床应用可以预测NAFLD。如果对高危患者使用腹部超声检查，则可以在NAFLD的早期进行诊断和管理。
