Zhu Jinzhou, He Mingqing, Zhang Yong, Li Tingxin, Liu Yuping, Xu Zhiye, Chen Weichang
Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China.
Department of Geriatrics, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China.
Endocr J. 2018 Mar 28;65(3):373-381. doi: 10.1507/endocrj.EJ17-0466. Epub 2018 Mar 9.
Various noninvasive algorithms have been developed for predicting the presence of nonalcoholic fatty liver disease (NAFLD). The evaluation of the indexes' diagnostic performance has been reported in Europe and Asia over the past decade; however, external validation of them in China is rare. This study was aimed to evaluate various indexes for NAFLD in western China. It was a retrospective cross-sectional study, using data from a large-scale health check-up project at Sichuan provincial hospital. Receiver operating characteristic (ROC) curves of eight indexes, including the fatty liver index (FLI), the hepatic steatosis index, lipid accumulation product and etc., were developed to predict ultrasonographic NAFLD. There were 13,122 subjects in this study (2,692 NAFLD patients and 10,430 non-NAFLD participants). The area under ROC curve of FLI for predicting NAFLD was 0.880 (95% confidence interval, 0.874-0.886), which was significantly higher than other seven indexes. Accuracy, sensitivity and specificity of FLI for NAFLD were good (cut-off value = 30, 0.782, 0.832, 0.770 and cut-off value = 60, 0.838, 0.443, 0.940, respectively). Furthermore, FLI also presented advantages in expenditure and accessibility, compared with other indexes. It supports FLI as an easily accessible index for physicians and a reliable predictor for NAFLD screening in western China.
已经开发出多种非侵入性算法来预测非酒精性脂肪性肝病（NAFLD）的存在。在过去十年中，欧洲和亚洲都报道了对这些指标诊断性能的评估；然而，在中国对其进行外部验证的情况却很少见。本研究旨在评估中国西部NAFLD的各种指标。这是一项回顾性横断面研究，使用了四川省医院大规模健康体检项目的数据。绘制了包括脂肪肝指数（FLI）、肝脂肪变性指数、脂质积聚产物等八项指标的受试者工作特征（ROC）曲线，以预测超声诊断的NAFLD。本研究共有13122名受试者（2692名NAFLD患者和10430名非NAFLD参与者）。FLI预测NAFLD的ROC曲线下面积为0.880（95%置信区间，0.874 - 0.886），显著高于其他七项指标。FLI对NAFLD的准确性、敏感性和特异性良好（临界值 = 30时，分别为0.782、0.832、0.770；临界值 = 60时，分别为0.838、0.443、0.940）。此外，与其他指标相比，FLI在费用和可及性方面也具有优势。这支持FLI作为医生易于获取的指标以及中国西部NAFLD筛查的可靠预测指标。
