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非酒精性脂肪性肝病的无创诊断:年龄和其他危险因素的影响。

Non-invasive diagnosis of nonalcoholic fatty liver disease: impact of age and other risk factors.

机构信息

Department of Internal Medicine, University of Health Sciences, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.

出版信息

Aging Male. 2020 Dec;23(5):1275-1282. doi: 10.1080/13685538.2020.1763293. Epub 2020 May 12.

Abstract

BACKGROUND AND OBJECTIVES

Little is known regarding the diagnostic performance of fibrosis scoring systems in the diagnosis of nonalcoholic fatty liver disease (NAFLD). We aimed to determine the risk factors of NAFLD and evaluate the diagnostic performance of noninvasive fibrosis scoring systems.

MATERIALS AND METHODS

The study included consecutive patients presented with dyspepsia from January 2017 to January 2019. Clinicodemographic and laboratory parameters including HOMA-IR were recorded. Anthropometric measurements were performed. NAFLD was diagnosed with ultrasonography. The FIB4, NAFLD, BARD, and Nippon scores were calculated.

RESULTS

Totally, 1008 patients were enrolled. The mean age was 52.3 ± 15 years in the NAFLD group (25.8%) and 36.7 ± 15.7 years in the non-NAFLD group (74.2%). The frequency of NAFLD was 25.8%. Age, body mass index (BMI), diabetes mellitus (DM), platelet count, HbA1c, HDL, ALT, and AST/ALT ratio were independent risk factors for NAFLD. The most sensitive and specific tests in diagnosing NAFLD were HOMA-IR and Nippon score, respectively.

CONCLUSIONS

Age, BMI, DM, HbA1c, platelet count, HDL, ALT, and AST/ALT ratio were independent predictors of NAFLD. The most specific and sensitive predictors of the presence of NAFLD were Nippon score and HOMA-IR value, respectively. The place of fibrosis scores in the diagnosis of NAFLD patients requires further scrutinization.

摘要

背景与目的

对于纤维化评分系统在非酒精性脂肪性肝病(NAFLD)诊断中的诊断性能,知之甚少。我们旨在确定 NAFLD 的危险因素,并评估非侵入性纤维化评分系统的诊断性能。

材料与方法

本研究纳入了 2017 年 1 月至 2019 年 1 月期间因消化不良就诊的连续患者。记录了临床和实验室参数,包括 HOMA-IR。进行了人体测量学测量。超声检查诊断为 NAFLD。计算了 FIB4、NAFLD、BARD 和 Nippon 评分。

结果

共纳入 1008 例患者。NAFLD 组(25.8%)的平均年龄为 52.3±15 岁,非 NAFLD 组(74.2%)的平均年龄为 36.7±15.7 岁。NAFLD 的发生率为 25.8%。年龄、体重指数(BMI)、糖尿病(DM)、血小板计数、HbA1c、高密度脂蛋白(HDL)、丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶/丙氨酸氨基转移酶比值是 NAFLD 的独立危险因素。诊断 NAFLD 最敏感和特异的检查分别是 HOMA-IR 和 Nippon 评分。

结论

年龄、BMI、DM、HbA1c、血小板计数、HDL、ALT 和 AST/ALT 比值是 NAFLD 的独立预测因素。Nippon 评分和 HOMA-IR 值是 NAFLD 存在的最特异和敏感的预测因素。纤维化评分在 NAFLD 患者诊断中的地位需要进一步研究。

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