S-Space College of Medicine/School of Medicine (의과대학/대학원) Internal Medicine (내과학전공) Journal Papers (저널논문_내과학전공)
NAFLD INDEX: A SIMPLE SCREENING TOOL REFLECTING NONALCOHOLIC FATTY LIVER DISEASE IN THE KOREAN POPULATION
- Issue Date
- ELSEVIER SCIENCE BV
- JOURNAL OF HEPATOLOGY; Vol.50 ; S25-S26
- Background and Aims: To optimize management of nonalcoholic fatty
liver disease (NAFLD), a simple screening tool is necessary. In this study,
we aimed to devise a simple index that reflects the presence of NAFLD
in the Korean population.
Methods: A cross-sectional study was conducted on 10,724 health checkup
subjects at a healthcare center (5,362 cases with NAFLD versus ageand
sex-matched controls). Study subjects were randomly assigned to a
derivation cohort or a validation cohort. An index reflecting the presence of
NAFLD was derived in the derivation cohort and validated in the validation
Results: Multivariable analysis indicated that body-mass index (BMI),
serum alanine aminotransferase (ALT) to serum aspartate aminotransferase
(AST) ratio, sex, and the presence of diabetes mellitus were independent
predictors of NAFLD. Using these variables, a formula was derived using a
linear regression model: NAFLD index (NAFLDI) = 8×ALT/AST ratio +
BMI (+3, if female; +2, if diabetes mellitus). NAFLDI had an area under
receiver-operating characteristics curve of 0.812 (95% confidence interval,
0.801−0.824). At a value of <31.0, NAFLDI ruled out NAFLD with a
sensitivity of 89.0% and a negative likelihood ratio of 0.22, and at a
value of >36.0, NAFLDI detected NAFLD with a specificity of 91.2%
and a positive likelihood ratio of 5.42. In the validation cohort, the
predictive power of NAFLDI was maintained at similar levels. NAFLDI
had significant correlation with sonographic fatty liver grade (adjusted
r2 = 0.334, P<0.001) (Figure 1).
Conclusion: NAFLDI was a simple, efficient screening tool for NAFLD
that could be utilized for selecting individuals for liver ultrasonography
and for determining the need for lifestyle modifications.
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