基于体检人群的非酒精性脂肪肝筛查工具的建立

发布时间：2018-05-06 15:42

本文选题：非酒精性脂肪肝 + 脂肪肝指数　；参考：《山东大学学报(医学版)》2017年06期

【摘要】：目的建立一个非酒精性脂肪肝(NAFLD)筛查模型并对其进行验证。方法对"山东多中心健康管理纵向观察队列"中8 993名接受健康体检且无过量饮酒个体随机抽取80%进行建模,并做组内评价,剩余20%作组外评价。通过逐步Logistic回归,建立NAFLD筛查模型,并进行评价及验证。结果多因素Logistic回归分析表明,性别、体质量指数、高血压、血脂异常、谷草转氨酶/谷丙转氨酶(AST/ALT)和血糖(FBG)进入了模型,构建了NAFLD筛查模型并可通过计算得到脂肪肝指数(fatty liver index,FLI)。筛查模型的鉴别能力采用受试者工作特征曲线下面积(AUC)进行评价(组内:0.859,95%CI:0.851~0.867;组外:0.853,95%CI:0.835~0.869)。当FLI≤1.25时排除疾病,组内和组外的阴性预测值分别为93.1%和93.3%,FLI≥2.25诊断为NAFLD,两组的阳性预测值分别为74.6%和72.7%。结论 FLI是一个简单有效的筛查工具,可以用于高危人群的筛查,具有一定的实用价值。
[Abstract]:Objective to establish a non-alcoholic fatty liver (NAFLD) screening model and to verify it. Methods a model was established for 8993 patients receiving healthy physical examination in the Shandong multi center health management longitudinal observation queue and 80% randomly selected individuals without excessive drinking, and the internal evaluation was done in the group and the remaining 20% was evaluated. By stepwise Logistic regression, NAFLD was established. The multiple factor Logistic regression analysis showed that sex, body mass index, hypertension, blood lipid abnormality, gluten transaminase / alanine aminotransferase (AST/ALT) and blood glucose (FBG) entered the model, and the NAFLD screening model was constructed and the fatty liver index (fatty liver index, FLI) could be calculated and the screening model was obtained. The identification ability was evaluated under the area under the subjects' working characteristic curve (AUC) (Group: 0.859,95%CI:0.851~0.867; outside group: 0.853,95%CI:0.835~0.869). When FLI was less than 1.25, the negative predictive values were 93.1% and 93.3%, respectively, and FLI more than 2.25 were NAFLD, and the positive predictive values of the two groups were 74.6% and 72.7%., respectively. FLI is a simple and effective screening tool. It can be used for screening high-risk groups and has practical value.

【作者单位】：山东大学公共卫生学院生物统计学系;山东大学齐鲁生物医学大数据中心;山东大学附属千佛山医院健康管理中心;山东电力中心医院;
【基金】：国家国际科技合作专项项目(2014DFA32830)
【分类号】：R575.5

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