Bedogni Giorgio, Tamini Sofia, Caroli Diana, Cicolini Sabrina, Domenicali Marco, Sartorio Alessandro
Clinical Epidemiology Unit, Liver Research Center, 34012 Basovizza, Italy.
Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Verbania, Italy.
J Clin Med. 2021 Apr 2;10(7):1470. doi: 10.3390/jcm10071470.
To develop predictive models of fatty liver (FL), we performed a cross-sectional retrospective study of 1672 obese children with a median (interquartile range) age of 15 (13-16) years. The outcome variable was FL diagnosed by ultrasonography. The potential predictors were: (1) binary: sex; (2) continuous: age, body mass index (BMI), waist circumference (WC), alanine transaminase (ALT), aspartate transaminase, gamma-glutamyltransferase, glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), HDL-cholesterol, LDL-cholesterol, triglycerides, mean arterial pressure, uric acid, and c-reactive protein; (3) ordinal: Pubertal status. Bootstrapped multivariable logistic regression with fractional polynomials was used to develop the models. Two models were developed and internally validated, one using BMI and the other using WC as the anthropometric predictor. Both models included ALT, HOMA-IR, triglycerides, and uric acid as predictors, had similar discrimination (c-statistic = 0.81), and were similarly well calibrated as determined by calibration plots. These models should undergo external validation before being employed in clinical or research practice.
为了开发脂肪肝（FL）的预测模型，我们对1672名肥胖儿童进行了一项横断面回顾性研究，这些儿童的年龄中位数（四分位间距）为15（13 - 16）岁。结局变量是通过超声检查诊断的脂肪肝。潜在预测因素包括：（1）二元变量：性别；（2）连续变量：年龄、体重指数（BMI）、腰围（WC）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶、γ-谷氨酰转移酶、葡萄糖、胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、平均动脉压、尿酸和C反应蛋白；（3）有序变量：青春期状态。使用带有分数多项式的自助式多变量逻辑回归来开发模型。开发并内部验证了两个模型，一个使用BMI作为人体测量学预测因素，另一个使用WC作为人体测量学预测因素。两个模型均将ALT、HOMA-IR、甘油三酯和尿酸作为预测因素，具有相似的辨别力（c统计量 = 0.81），并且根据校准图确定校准效果相似。在临床或研究实践中应用这些模型之前，应进行外部验证。
