Foschi Francesco Giuseppe, Conti Fabio, Domenicali Marco, Giacomoni Pierluigi, Borghi Alberto, Bevilacqua Vittoria, Napoli Lucia, Berardinelli Dante, Altini Mattia, Cucchetti Alessandro, Ercolani Giorgio, Casadei-Gardini Andrea, Bellentani Stefano, Gastaldelli Amalia, Tiribelli Claudio, Bedogni Giorgio, Group Bagnacavallo Study
Azienda Unità Sanitaria della Romagna, Ospedale degli Infermi, 48018 Faenza, Italy.
Faculty of Medicine and Surgery, University of Bologna, 40138 Bologna, Italy.
J Clin Med. 2021 Feb 1;10(3):520. doi: 10.3390/jcm10030520.
We externally validated the fatty liver index (FLI), the lipid accumulation product (LAP), the hepatic steatosis index (HSI), and the Zhejiang University index (ZJU) for the diagnosis of fatty liver (FL) and non-alcoholic fatty liver disease (NAFLD) in the general population. The validation was performed on 2159 citizens of the town of Bagnacavallo (Ravenna, Italy). Calibration was evaluated by calculating the calibration slope and intercept and by inspecting calibration plots; discrimination was evaluated using the c-statistic. The average calibration slope was 1 and the average intercept was 0 for all combinations of outcomes and indices. For the diagnosis of FL, the c-statistic was 0.85 for FLI, 0.83 for ZJU, 0.82 for HSI, and 0.80 for LAP; for the diagnosis of NAFLD, the c-statistic was 0.77 for FLI, 0.76 for ZJU, 0.75 for HSI, and 0.74 for LAP. All indices were strongly correlated with each other. In conclusion, FLI, LAP, HSI, and ZJU perform similarly well to diagnose FL and NAFLD in the Bagnacavallo population, even if FLI has a small advantage as discrimination is concerned.
我们对外验证了脂肪肝指数（FLI）、脂质蓄积产物（LAP）、肝脂肪变性指数（HSI）和浙江大学指数（ZJU）在普通人群中诊断脂肪肝（FL）和非酒精性脂肪性肝病（NAFLD）的性能。验证工作在意大利拉文纳省巴尼亚卡瓦洛镇的2159名居民中进行。通过计算校准斜率和截距并检查校准图来评估校准情况；使用c统计量评估鉴别能力。对于所有结局和指数的组合，平均校准斜率为1，平均截距为0。对于FL的诊断，FLI的c统计量为0.85，ZJU为0.83，HSI为0.82，LAP为0.80；对于NAFLD的诊断，FLI的c统计量为0.77，ZJU为0.76，HSI为0.75，LAP为0.74。所有指数之间都高度相关。总之，在巴尼亚卡瓦洛人群中，FLI、LAP、HSI和ZJU在诊断FL和NAFLD方面表现相似，尽管就鉴别能力而言FLI略有优势。
