Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Eur J Gastroenterol Hepatol. 2024 Oct 1;36(10):1209-1219. doi: 10.1097/MEG.0000000000002806. Epub 2024 Jun 26.
Fatty Liver Index (FLI), Triglyceride-Glucose Index (TyG), Lipid Accumulation Product (LAP), Zhejiang University Index (ZJU), and Visceral Adiposity Index (VAI) are five classical predictive models for fatty liver disease. Our cross-sectional study aimed to identify the optimal predictors by comparing the predictive value of five models for metabolic dysfunction-associated steatotic liver disease (MASLD) risk.
Data on 2687 participants were collected from West China Hospital of Sichuan University. Controlled attenuation parameters assessed by transient elastography were used to effectively diagnose MASLD. Logistic regression analysis was used to estimate the odd ratios and 95% confidence intervals between indices and MASLD risk. Receiver operating characteristic curves were plotted to evaluate the predictive value of indices.
This study included 1337 normal and 1350 MASLD samples. The average age of MASLD patients is 47 years old, and the prevalence was higher in males (39.3%) than in females (10.9%). Five indices were positively correlated with MASLD risk, with the strongest correlation for TyG. Overall, the area under the curve of the indicators was: ZJU 0.988, FLI 0.987, LAP 0.982, TyG 0.942, and VAI 0.941. In the gender stratification, ZJU (0.989) performed best in males. FLI (0.988) and ZJU (0.987) had similar predictive ability in females. In the age stratification, FLI performed better in predicting the middle-aged group aged 30-40 years (0.991).
For Chinese Han adults, ZJU is the best predictive index for initial screening of MASLD. FLI can serve as an alternative tool for ZJU to predict females.
脂肪肝指数（FLI）、甘油三酯-葡萄糖指数（TyG）、脂质堆积产物（LAP）、浙江大学指数（ZJU）和内脏脂肪指数（VAI）是五种经典的脂肪肝疾病预测模型。本横断面研究旨在通过比较五种模型对代谢相关脂肪性肝病（MASLD）风险的预测价值，确定最佳预测因子。
本研究共纳入 2687 名来自四川大学华西医院的参与者。使用瞬时弹性成像评估受控衰减参数，有效诊断 MASLD。使用 logistic 回归分析估计各指数与 MASLD 风险之间的比值比及其 95%置信区间。绘制受试者工作特征曲线评估各指数的预测价值。
本研究纳入 1337 例正常和 1350 例 MASLD 样本。MASLD 患者的平均年龄为 47 岁，男性（39.3%）患病率高于女性（10.9%）。五项指数与 MASLD 风险呈正相关，其中 TyG 的相关性最强。总体而言，各指标的曲线下面积为：ZJU 0.988、FLI 0.987、LAP 0.982、TyG 0.942 和 VAI 0.941。在性别分层中，ZJU 在男性中表现最佳（0.989）。在女性中，FLI（0.988）和 ZJU（0.987）具有相似的预测能力。在年龄分层中，FLI 在预测 30-40 岁的中年人群中表现更好（0.991）。
对于中国汉族成年人，ZJU 是 MASLD 初筛的最佳预测指标。FLI 可以作为替代 ZJU 的工具，用于预测女性。
