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External validation and comparison of simple tools to screen for nonalcoholic fatty liver disease in Chinese community population
Zhang, Liuxina,*; Zhang, Mengtingb,*; Wang, Minb; Wang, Minxianb; Zhang, Rub; Wang, Hongliangc; Zhang, Weid; Ding, Yajieb; Wang, Jieb
Author Information
aDepartment of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University
bDepartment of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University
cDepartment of General Practice, Ninghai Road Community Health Service Center of Nanjing, Nanjing
dDepartment of Epidemiology, Shanghai Cancer Institute, Shanghai, China
Received 3 March 2022 Accepted 12 April 2022
*Liuxin Zhang and Mengting Zhang contributed equally to the writing of this article.
Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website, www.eurojgh.com.
Correspondence to Jie Wang, PhD, Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, No. 101 Longmian Avenue, Jiangning District, Nanjing 211166, Jiangsu, China, Tel: +86 25 8686 9557; e-mail: [email protected].
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
European Journal of Gastroenterology & Hepatology: August 2022 - Volume 34 - Issue 8 - p 865-872
doi: 10.1097/MEG.0000000000002399
Open
SDC
Abstract
Background
Various noninvasive tools based on anthropometric indicators, blood lipids, and liver enzymes, etc. have been developed to screen for nonalcoholic fatty liver disease (NAFLD), with different diagnostic performance and cutoff values among studies. We aimed to validate and compare eight NAFLD-related models developed by simple indicators and to define their cutoff values in Chinese community population.
Methods
A cross-sectional study was conducted in a health examination cohort of 3259 people. NAFLD was diagnosed by ultrasonography. General, anthropometric and biochemical data were collected. Fatty liver index (FLI), fatty liver disease index (FLD), Zhejiang University index (ZJU), lipid accumulation product (LAP), regression formula of controlled attenuation parameter (CAP), waist-to-height ratio (WHtR), triglyceride and glucose index (TyG), and visceral adiposity index (VAI) were calculated. The accuracy and cutoff points to detect NAFLD were evaluated by area under the receiver operator characteristic curve and the maximum Youden index analysis, respectively. A head-to-head comparison between these models and Decision Curve Analysis (DCA) was conducted.
Results
In eight noninvasive diagnostic models of NAFLD, AUCs of FLI and FLD for NAFLD were higher than those of other models in the whole (0.852 and 0.852), male (0.826 and 0.824), and female (0.897 and 0.888) population, respectively. DCA showed that FLI, FLD, and ZJU have higher net benefit to screen for NAFLD compared to other models.
Conclusions
FLI and FLD could be the most accurate and applicable of eight models for the noninvasive diagnosis of NAFLD in both male and female groups.
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发表于 2022-7-11 21:33