Liu Hanying, Li Xiao, Han Xiaodong, Zhang Yan, Gu Yanting, Sun Lianjie, Han Junfeng, Tu Yinfang, Bao Yuqian, Bai Wenkun, Yu Haoyong
Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China.
Front Med (Lausanne). 2022 Jul 22;9:894895. doi: 10.3389/fmed.2022.894895. eCollection 2022.
Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease. The controlled attenuation parameter (CAP) obtained by FibroScan reflects the level of liver steatosis in patients with obesity. Our study aimed to construct a simple equation to predict the CAP, to facilitate the screening and monitoring of patients at high risk for NAFLD.
A total of 272 subjects were randomly divided into derivation and validation cohorts at a ratio of 1:2. The derivation set was used for constructing a multiple linear regression model; the validation set was used to verify the validity of the model.
Several variables strongly correlated with the CAP were used to construct the following equation for predicting CAP values:CAP1 = 2.4 × BMI + 10.5 × TG+ 3.6 × NC + 10.3 × CP +31.0, where BMI is body mass index, TG is triglyceride, NC is neck circumference and CP is C-peptide. The CAP1 model had an of 0.764 and adjusted of 0.753. It was then simplified to derive CAP2 included only simple anthropometric parameters: CAP2 = 3.5 × BMI + 4.2 × NC + 20.3 ( = 0.696, adjusted = 0.689). The data were well fitted by both models. In the verification group, the predicted (CAP1 and CAP2) values were compared to the actual CAP values. For the CAP1 equation, = 0.653, adjusted = 0.651. For the CAP2 equation, = 0.625, adjusted = 0.623. The intra-class correlation coefficient (ICC) values were 0.781 for CAP1 and 0.716 for CAP2 ( < 0.001). The actual CAP and the predicted CAP also showed good agreement in Bland-Altman plot.
The equations for predicting the CAP value comprise easily accessible variables, and showed good stability and predictive power. Thus, they can be used as simple surrogate tools for early screening and follow-up of NAFLD in the Chinese population.
非酒精性脂肪性肝病（NAFLD）是慢性肝病的主要病因之一。通过FibroScan获得的受控衰减参数（CAP）反映了肥胖患者的肝脏脂肪变性水平。我们的研究旨在构建一个简单方程来预测CAP，以促进NAFLD高危患者的筛查和监测。
总共272名受试者按1:2的比例随机分为推导队列和验证队列。推导集用于构建多元线性回归模型；验证集用于验证模型的有效性。
使用几个与CAP密切相关的变量构建以下预测CAP值的方程：CAP1 = 2.4×体重指数 + 10.5×甘油三酯 + 3.6×颈围 + 10.3×C肽 + 31.0，其中体重指数是体重指数，甘油三酯是甘油三酯，颈围是颈围，C肽是C肽。CAP1模型的R²为0.764，调整后的R²为0.753。然后将其简化以得出仅包含简单人体测量参数的CAP2：CAP2 = 3.5×体重指数 + 4.2×颈围 + 20.3（R² = 0.696，调整后的R² = 0.689）。两个模型对数据的拟合都很好。在验证组中，将预测的（CAP1和CAP2）值与实际CAP值进行比较。对于CAP1方程，R² = 0.653，调整后的R² = 0.651。对于CAP2方程，R² = 0.625，调整后的R² = 0.623。CAP1的组内相关系数（ICC）值为0.781，CAP2的为0.716（P < 0.001）。在Bland-Altman图中，实际CAP与预测CAP也显示出良好的一致性。
预测CAP值的方程包含易于获取的变量，并且显示出良好的稳定性和预测能力。因此，它们可以作为中国人群中NAFLD早期筛查和随访的简单替代工具。
