Xia Bei, He He, Qin Ken, Li Shuang-Qing, An Zhen-Mei
Department of Medical Genetics, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 May;54(3):591-595. doi: 10.12182/20230560109.
To analyze the risk factors of metabolic dysfunction-associated fatty liver disease (MAFLD) in the physical examination population, to establish a risk prediction model for the occurrence of MAFLD, and to provide management strategies for the prevention and occurrence of the disease.
A total of 14664 people who underwent physical examination at the Physical Examination Center, West China Hospital, Sichuan University between January 2018 and December 2021 were selected as research subjects. The subjects were divided into a MAFLD group ( =4013) and a non-MAFLD group ( =10651) according to whether they had MAFLD. The differences in biochemical indices, for example, glycolipid metabolism levels, were compared and logistic regression was conducted to analyze the risk factors for MAFLD, thereby establishing a nomogram prediction model. The prediction effect of the model was validated and evaluated with the consistency index (C-index) and the calibration curve.
Among the 14664 subjects who underwent physical examination, 4013 were MAFLD patients, presenting an overall prevalence of 27.37%, with significantly higher prevalence in men than that in women (38.99% vs. 10.06%, <0.001). Compared with those of the non-MAFLD group, the levels of glucose (GLU), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), aspartate transaminase (AST), alanine transaminase (ALT), gamma-glutamyl transpeptidase (GGT) and uric acid (UA) were increased ( <0.05), while the high density lipoprotein cholesterol (HDL-C) level was decreased ( <0.05) in the MAFLD group. The results of logistic regression analysis showed that male sex, age, body mass index, GLU, TG and hypertension were all independent risk factors of MAFLD, while HDL-C was a protective factor of MAFLD. The risk factors were used to establish a nomogram risk prediction model and the C-index and calibration curve showed that the nomogram model produced good predictive performance. The receiver operating characteristic (ROC) curve showed that the nomogram model had good predictive value for the risk of MAFLD.
We found a relatively high prevalence of MAFLD in the physical examination population, and the nomogram model established with routine physical examination screening can provide indications for the clinical screening and analysis of high-risk patients, which has an early warning effect on the high-risk population.
分析体检人群中代谢功能障碍相关脂肪性肝病（MAFLD）的危险因素，建立MAFLD发生的风险预测模型，并为该病的预防和发生提供管理策略。
选取2018年1月至2021年12月在四川大学华西医院体检中心接受体检的14664人作为研究对象。根据是否患有MAFLD将研究对象分为MAFLD组（n = 4013）和非MAFLD组（n = 10651）。比较糖脂代谢水平等生化指标的差异，并进行逻辑回归分析MAFLD的危险因素，从而建立列线图预测模型。采用一致性指数（C指数）和校准曲线对模型的预测效果进行验证和评估。
在14664名接受体检的研究对象中，MAFLD患者有4013例，总体患病率为27.37%，男性患病率显著高于女性（38.99%对10.06%，P < 0.001）。与非MAFLD组相比，MAFLD组的血糖（GLU）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、γ-谷氨酰转肽酶（GGT）和尿酸（UA）水平升高（P < 0.05），而高密度脂蛋白胆固醇（HDL-C）水平降低（P < 0.05）。逻辑回归分析结果显示，男性、年龄、体重指数、GLU、TG和高血压均为MAFLD的独立危险因素，而HDL-C是MAFLD的保护因素。利用这些危险因素建立列线图风险预测模型，C指数和校准曲线表明列线图模型具有良好的预测性能。受试者工作特征（ROC）曲线显示，列线图模型对MAFLD风险具有良好的预测价值。
我们发现体检人群中MAFLD的患病率相对较高，通过常规体检筛查建立的列线图模型可为临床筛查和分析高危患者提供参考，对高危人群具有预警作用。
