Zhang Pengzi, Feng Wenhuan, Chu Xuehui, Sun Xitai, Zhu Dalong, Bi Yan
Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, No 321, Zhongshan Road, Nanjing, 210008, Jiangsu, China.
Department of General Surgery, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
BMC Gastroenterol. 2019 Nov 27;19(1):202. doi: 10.1186/s12876-019-1120-z.
To investigate the value of prolactin (PRL) in diagnosing non-alcoholic fatty liver disease (NAFLD).
Metabolic parameters and serum PRL levels were measured in 452 males and 421 females, who were randomized to the estimation or the validation group as a 1:1 ratio. Hepatic steatosis was diagnosed via abdominal ultrasound. Variables that significantly associated with NAFLD in univariate analysis were included in multiple logistic regression. We used the receiver operator characteristic (ROC) curves to test the model performance. Besides, 147 patients underwent metabolic and liver biopsy were analyzed to validate the diagnostic value of this model.
Body mass index, alanine aminotransferase, prolactin, high density lipoprotein cholesterol and HbA1c were included into models. In males, the area under ROC curve (AUC) was 0.86 (95%CI: 0.82-0.91) for the validation group. With two cut-off points (- 0.79 and 1.71), the sensitivity and specificity for predicting NALFD was 95.2 and 91.1% in the validation group, respectively. In females, the AUC was 0.82 (95%CI: 0.76-0.88) for the validation group. With two cut-off points (- 0.68 and 2.16), the sensitivity and specificity for predicting NALFD was 97.1 and 91.4% in the validation group, respectively. In subjects with liver pathology, the AUC was higher than that of fatty liver index. A positive correlation between the scores of the model and the severities of NAFLD was observed. Importantly, we demonstrated a potential value of this model in predicting nonalcoholic steatohepatitis.
We established a mathematic model that can conveniently and effectively diagnose the existence and severities of NAFLD.
探讨催乳素(PRL)在诊断非酒精性脂肪性肝病(NAFLD)中的价值。
对452名男性和421名女性进行代谢参数和血清PRL水平测定,这些受试者按1:1比例随机分为评估组或验证组。通过腹部超声诊断肝脂肪变性。单因素分析中与NAFLD显著相关的变量纳入多因素逻辑回归分析。采用受试者工作特征(ROC)曲线检验模型性能。此外,对147例行代谢和肝活检的患者进行分析以验证该模型的诊断价值。
体重指数、丙氨酸氨基转移酶、催乳素、高密度脂蛋白胆固醇和糖化血红蛋白被纳入模型。在男性中,验证组的ROC曲线下面积(AUC)为0.86(95%CI:0.82 - 0.91)。有两个截断点(-0.79和1.71)时,验证组预测NAFLD的敏感性和特异性分别为95.2%和91.1%。在女性中,验证组的AUC为0.82(95%CI:0.76 - 0.88)。有两个截断点(-0.68和2.16)时,验证组预测NAFLD的敏感性和特异性分别为97.1%和91.4%。在有肝脏病理结果的受试者中,AUC高于脂肪肝指数。观察到模型得分与NAFLD严重程度之间呈正相关。重要的是,我们证明了该模型在预测非酒精性脂肪性肝炎方面的潜在价值。
我们建立了一个数学模型,可方便有效地诊断NAFLD的存在及严重程度。