Wang Jinghua, Xu Chengfu, Xun Yunhao, Lu Zhenya, Shi Junping, Yu Chaohui, Li Youming
Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Department of Liver Diseases, Xixi Hospital of Hangzhou, Hangzhou, Zhejiang, China.
Sci Rep. 2015 Nov 16;5:16494. doi: 10.1038/srep16494.
Non-alcoholic fatty liver disease (NAFLD) is an important health issue worldwide. We aimed to develop a simple model to determine the presence of NAFLD in a Chinese population. A cross-sectional study with 9602 subjects was conducted. Potential predictors were entered into a stepwise logistic regression analysis to obtain the model. We used 148 patients with liver biopsy to validate this model. The model, named the ZJU index, was developed based on body mass index (BMI), fasting plasma glucose (FPG), triglycerides (TG), and the serum alanine aminotransferase (ALT) to serum aspartate transaminase (AST) ratio. The area under the receiver operating characteristic curve (AUROC) of the ZJU index to detect NAFLD was 0.822. At a value of <32.0, the ZJU index could rule out NAFLD with a sensitivity of 92.2%, and at a value of >38.0, the ZJU index could detect NAFLD with a specificity of 93.4%. In patients with liver biopsy, the ZJU index could detect steatosis with good accuracy, with an AUROC of 0.896. This study revealed that the ZJU index is a helpful model to detect NAFLD for community physicians in China. It was validated not only by a validation cohort but also by pathological data.
非酒精性脂肪性肝病（NAFLD）是一个全球性的重要健康问题。我们旨在开发一种简单的模型来确定中国人群中NAFLD的存在情况。我们进行了一项针对9602名受试者的横断面研究。将潜在的预测因素纳入逐步逻辑回归分析以获得该模型。我们使用148例肝活检患者来验证此模型。该模型名为ZJU指数，是基于体重指数（BMI）、空腹血糖（FPG）、甘油三酯（TG）以及血清丙氨酸氨基转移酶（ALT）与血清天冬氨酸氨基转移酶（AST）的比值建立的。ZJU指数检测NAFLD的受试者工作特征曲线下面积（AUROC）为0.822。当ZJU指数值<32.0时，其排除NAFLD的灵敏度为92.2%，当ZJU指数值>38.0时，其检测NAFLD的特异度为93.4%。在肝活检患者中，ZJU指数能够以良好的准确性检测脂肪变性，AUROC为0.896。本研究表明，ZJU指数是中国社区医生检测NAFLD的一个有用模型。它不仅通过验证队列进行了验证，还通过病理数据进行了验证。
