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墨西哥胆结石病患者非酒精性脂肪性肝病诊断的预测模型:性别特异性见解

Predictive Models for Non-Alcoholic Fatty Liver Disease Diagnosis in Mexican Patients with Gallstone Disease: Sex-Specific Insights.

作者信息

Rodríguez-Hernández Nemry, Lazo-de-la-Vega-Monroy María-Luisa, Ruiz-Noa Yeniley, Preciado-Puga Monica-Del-Carmen, Garcia-Ramirez Juana-Rosalba, Jordan-Perez Benjamin, Garnelo-Cabañas Serafin, Ibarra-Reynoso Lorena-Del-Rocío

机构信息

Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Leon de los Aldama 37320, Mexico.

Department of Medicine and Nutrition, Health Sciences Division, University of Guanajuato, Leon Campus, Leon de los Aldama 37320, Mexico.

出版信息

Diagnostics (Basel). 2024 Jul 11;14(14):1487. doi: 10.3390/diagnostics14141487.

Abstract

(1) Background: Evidence regarding Non-Alcoholic Fatty Liver Disease (NAFLD) diagnosis is limited in the context of patients with gallstone disease (GD). This study aimed to assess the predictive potential of conventional clinical and biochemical variables as combined models for diagnosing NAFLD in patients with GD. (2) Methods: A cross-sectional study including 239 patients with GD and NAFLD diagnosed by ultrasonography who underwent laparoscopic cholecystectomy and liver biopsy was conducted. Previous clinical indices were also determined. Predictive models for the presence of NAFLD stratified by biological sex were obtained through binary logistic regression and sensitivity analyses were performed. (3) Results: For women, the model included total cholesterol (TC), age and alanine aminotransferase (ALT) and showed an area under receiver operating characteristic curve (AUC) of 0.727 ( < 0.001), sensitivity of 0.831 and a specificity of 0.517. For men, the model included TC, body mass index (BMI) and aspartate aminotransferase (AST), had an AUC of 0.898 ( < 0.001), sensitivity of 0.917 and specificity of 0.818. In both sexes, the diagnostic performance of the designed equations was superior to the previous indices. (4) Conclusions: These models have the potential to offer valuable guidance to healthcare providers in clinical decision-making, enabling them to achieve optimal outcomes for each patient.

摘要

(1)背景:在胆结石疾病(GD)患者中,关于非酒精性脂肪性肝病(NAFLD)诊断的证据有限。本研究旨在评估传统临床和生化变量作为联合模型对GD患者NAFLD的预测潜力。(2)方法:进行了一项横断面研究,纳入239例经超声诊断为GD和NAFLD且接受了腹腔镜胆囊切除术和肝活检的患者。还确定了既往临床指标。通过二元逻辑回归获得按生物学性别分层的NAFLD存在的预测模型,并进行了敏感性分析。(3)结果:对于女性,模型包括总胆固醇(TC)、年龄和丙氨酸氨基转移酶(ALT),受试者操作特征曲线下面积(AUC)为0.727(<0.001),敏感性为0.831,特异性为0.517。对于男性,模型包括TC、体重指数(BMI)和天冬氨酸氨基转移酶(AST),AUC为0.898(<0.001),敏感性为0.917,特异性为0.818。在两性中,所设计方程的诊断性能均优于既往指标。(4)结论:这些模型有可能为医疗保健提供者的临床决策提供有价值的指导,使他们能够为每位患者实现最佳结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a60f/11275442/9d36db06adfa/diagnostics-14-01487-g001.jpg

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