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非酒精性脂肪性肝病风险评分:一种预测非酒精性脂肪肝4年风险的简单评分模型。

The NAFL Risk Score: A simple scoring model to predict 4-y risk for non-alcoholic fatty liver.

作者信息

Zhou Yu-Jie, Zheng Ji-Na, Liu Wen-Yue, Miele Luca, Vitale Alessandro, Van Poucke Sven, Zou Tian-Tian, Fang Dan-Hong, Shen Shengrong, Zhang Dong-Chu, Zheng Ming-Hua

机构信息

Department of Hepatology, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China.

Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Clin Chim Acta. 2017 May;468:17-24. doi: 10.1016/j.cca.2017.01.021. Epub 2017 Jan 19.

Abstract

BACKGROUND

Although several risk factors for non-alcoholic fatty liver (NAFL) have been reported, there are few clinical scores that predict its incidence in the long term. We developed and validate a scoring model for individual prediction of 4-y risk for NAFL.

METHODS

Four-year follow-up data of 8226 initially NAFL-free subjects enrolled for an annual physical examination from Wenzhou Medical Center were analyzed. These subjects are randomly split into the training and the validation cohort. Univariate and multivariable logistic regression models were employed for model development. The selected variables were assigned an integer or half-integer risk score proportional to the estimated coefficient from the logistic model. Risk scores were tested in a validation cohort. We also compared the predictive performance of with that of the NAFLD Index by computing the area under the receiver operating characteristic curve (AUROC).

RESULTS

The NAFL Risk Score was developed as 0 to 18 points comprising of BMI, TG×GGT, ALT/AST, LDL-C/HDL-C and UA in both sexes. Comparison of the observed with the estimated incidence of NAFL at both cohorts showed satisfactory precision. In addition, the NAFL Risk Score showed relatively good discriminative power (AUROC=0.739 for males, 0.823 for females) compared with the NAFLD Index (AUROC=0.661 for males, 0.729 for females) in these Chinese subjects.

CONCLUSIONS

We developed and validated the NAFL Risk Score, a new scoring model to predict 4-y risk for NAFL. The NAFL Risk Score may be clinically simple and useful for assessing individual risk for NAFL.

摘要

背景

尽管已报道了非酒精性脂肪肝(NAFL)的多种危险因素,但长期预测其发病率的临床评分较少。我们开发并验证了一种用于个体预测NAFL 4年发病风险的评分模型。

方法

分析了温州医科大学附属第一医院8226名最初无NAFL的受试者的4年随访数据,这些受试者参加年度体检。这些受试者被随机分为训练队列和验证队列。采用单变量和多变量逻辑回归模型进行模型开发。根据逻辑模型估计系数,为所选变量分配整数或半整数风险评分。在验证队列中对风险评分进行测试。我们还通过计算受试者工作特征曲线下面积(AUROC)比较了该模型与非酒精性脂肪性肝病(NAFLD)指数的预测性能。

结果

NAFL风险评分范围为0至18分,由男女的体重指数(BMI)、甘油三酯(TG)×γ-谷氨酰转肽酶(GGT)、谷丙转氨酶(ALT)/谷草转氨酶(AST)、低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)和尿酸(UA)组成。两个队列中NAFL的观察发病率与估计发病率比较显示出令人满意的准确性。此外,在这些中国受试者中,与NAFLD指数(男性AUROC = 0.661,女性AUROC = 0.729)相比,NAFL风险评分显示出相对较好的鉴别能力(男性AUROC = 0.739,女性AUROC = 0.823)。

结论

我们开发并验证了NAFL风险评分,这是一种预测NAFL 4年发病风险的新评分模型。NAFL风险评分在临床上可能简单且有助于评估个体患NAFL的风险。

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