Department of Gastroenterology, The First People's Hospital of Yuhang District, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2021 Jul 2;100(26):e26415. doi: 10.1097/MD.0000000000026415.
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, and its pathogenesis is complicated and triggered by unbalanced diet, sedentary lifestyle, and genetic background. The aim of this study was to construct and validate a nomogram incorporated lifestyle habits for predicting NAFLD incidence.The overall cohort was divided into training set and test set as using computer-generated random numbers. We constructed the nomogram by multivariate logistic regression analysis in the training set. Thereafter, we validated this model by concordance index, the area under the receiver operating characteristic curve (ROC), net reclassification index, and a calibration curve in the test set. Additionally, we also evaluated the clinical usefulness of the nomogram by decision curve analysis.There were no statistically significant differences about characteristics between training cohort (n = 748) and test cohort (n = 320). Eleven features (age, sex, body mass index, drinking tea, physical exercise, energy, monounsaturated fatty acids, polyunsaturated fatty acids, hypertension, hyperlipidemia, diabetes) were incorporated to construct the nomogram, concordance index, the area under the ROC curve, net reclassification index were 0.801, 0.801, and 0.084, respectively, indicating the nomogram have good discrimination of predicting NAFLD incidence. Also, the calibration curve showed good consistency between nomogram prediction and actual probability. Moreover, the decision curve showed that when the threshold probability of an individual is within a range from approximately 0.5 to 0.8, this model provided more net benefit to predict NAFLD incidence risk than the current strategies.This nomogram can be regarded as a user-friendly tool for assessing the risk of NAFLD incidence, and thus help to facilitate management of NAFLD including lifestyle and medical interventions.
非酒精性脂肪性肝病 (NAFLD) 是最常见的慢性肝病,其发病机制复杂,与饮食失衡、久坐不动的生活方式和遗传背景有关。本研究旨在构建并验证一个纳入生活方式习惯的列线图,用于预测 NAFLD 的发病风险。
整个队列使用计算机生成的随机数分为训练集和测试集。我们通过多元逻辑回归分析在训练集中构建了列线图。然后,我们通过一致性指数、接收者操作特征曲线(ROC)下的面积、净重新分类指数和测试集中的校准曲线在测试集中验证了该模型。此外,我们还通过决策曲线分析评估了该列线图的临床实用性。
在训练队列(n=748)和测试队列(n=320)中,特征之间没有统计学上的显著差异。该列线图纳入了 11 个特征(年龄、性别、体重指数、饮茶、体育锻炼、能量、单不饱和脂肪酸、多不饱和脂肪酸、高血压、高血脂、糖尿病),一致性指数、ROC 曲线下面积、净重新分类指数分别为 0.801、0.801 和 0.084,表明该列线图对预测 NAFLD 发病风险具有良好的区分能力。此外,校准曲线显示列线图预测与实际概率之间具有良好的一致性。而且,决策曲线表明,当个体的阈值概率在约 0.5 到 0.8 的范围内时,该模型在预测 NAFLD 发病风险方面比当前策略提供了更多的净获益。
该列线图可作为评估 NAFLD 发病风险的简便易用的工具,有助于包括生活方式和医学干预在内的 NAFLD 的管理。