School of Public Health, Qingdao University, Qingdao, China.
Qingdao Centers for Disease Control and Prevention/Qingdao Institute for Preventive Medicine, Qingdao China.
Asia Pac J Clin Nutr. 2024 Mar;33(1):83-93. doi: 10.6133/apjcn.202403_33(1).0009.
To explore the risk factors for non-alcoholic fatty liver disease (NAFLD) and to establish a non-invasive tool for the screening of NAFLD in an older adult population.
A total of 131,161 participants were included in this cross-sectional study. Participants were randomly divided into training and validation sets (7:3). The least absolute shrinkage and selection operator method was used to screen risk factors. Multivariate logistic regression was employed to develop a nomogram, which was made available online. Receiver operating characteristic curve analysis, calibration plots, and decision curve analysis were used to validate the discrimination, calibration, and clinical practicability of the nomogram. Sex and age subgroup analyses were conducted to further validate the reliability of the model.
Nine variables were identified for inclusion in the nomogram (age, sex, waist circumference, body mass index, exercise frequency, systolic blood pressure, fasting plasma glucose, alanine aminotransferase, and low-density lipoprotein cholesterol). The area under the receiver operating characteristic curve values were 0.793 and 0.790 for the training set and the validation set, respectively. The calibration plots and decision curve analyses showed good calibration and clinical utility. Subgroup analyses demonstrated consistent discriminatory ability in different sex and age subgroups.
This study established and validated a new nomogram model for evaluating the risk of NAFLD among older adults. The nomogram had good discriminatory performance and is a non-invasive and convenient tool for the screening of NAFLD in older adults.
探讨非酒精性脂肪性肝病(NAFLD)的危险因素,并建立一种适用于老年人群的 NAFLD 筛查的无创工具。
本横断面研究共纳入 131161 名参与者。参与者被随机分为训练集和验证集(7:3)。使用最小绝对收缩和选择算子法筛选危险因素。采用多变量逻辑回归建立列线图,并在网上提供。使用受试者工作特征曲线分析、校准图和决策曲线分析来验证列线图的区分度、校准度和临床实用性。进行性别和年龄亚组分析,以进一步验证模型的可靠性。
共确定了 9 个变量纳入列线图(年龄、性别、腰围、体重指数、运动频率、收缩压、空腹血糖、丙氨酸氨基转移酶和低密度脂蛋白胆固醇)。训练集和验证集的受试者工作特征曲线下面积分别为 0.793 和 0.790。校准图和决策曲线分析显示良好的校准度和临床实用性。亚组分析表明,在不同性别和年龄亚组中,该模型具有一致的判别能力。
本研究建立并验证了一种用于评估老年人群 NAFLD 风险的新列线图模型。该列线图具有良好的判别性能,是一种用于老年人群 NAFLD 筛查的无创、方便的工具。