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Non-laboratory-based self-assessment screening score for non-alcoholic fatty liver disease: development, validation and comparison with other scores.

 Yongho Lee  ;  Heejung Bang  ;  Young Min Park  ;  Ji Cheol Bae  ;  Byung Wan Lee  ;  Eun Seok Kang  ;  Bong Soo Cha  ;  Hyun Chul Lee  ;  Beverley Balkau  ;  Won Young Lee  ;  Dae Jung Kim 
 PLOS ONE, Vol.9(9) : e107584, 2014 
Journal Title
Issue Date
Adult ; Alcohol Drinking ; Anthropometry* ; Body Mass Index ; Diabetes Mellitus/diagnosis ; Diabetes Mellitus/pathology ; Diagnostic Self Evaluation* ; Fatty Liver/diagnosis* ; Fatty Liver/pathology ; Female ; Fibrosis/diagnosis ; Fibrosis/pathology ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/diagnosis* ; Non-alcoholic Fatty Liver Disease/pathology ; Obesity/diagnosis ; Obesity/pathology ; Republic of Korea ; Waist Circumference
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a prevalent and rapidly increasing disease worldwide; however, no widely accepted screening models to assess the risk of NAFLD are available. Therefore, we aimed to develop and validate a self-assessment score for NAFLD in the general population using two independent cohorts. METHODS: The development cohort comprised 15676 subjects (8313 males and 7363 females) who visited the National Health Insurance Service Ilsan Hospital in Korea in 2008-2010. Anthropometric, clinical, and laboratory data were examined during regular health check-ups and fatty liver diagnosed by abdominal ultrasound. Logistic regression analysis was conducted to determine predictors of prevalent NAFLD and to derive risk scores/models. We validated our models and compared them with other existing methods using an external cohort (N = 66868). RESULTS: The simple self-assessment score consists of age, sex, waist circumference, body mass index, history of diabetes and dyslipidemia, alcohol intake, physical activity and menopause status, which are independently associated with NAFLD, and has a value of 0-15. A cut-off point of ≥ 8 defined 58% of males and 36% of females as being at high-risk of NAFLD, and yielded a sensitivity of 80% in men (77% in women), a specificity of 67% (81%), a positive predictive value of 72% (63%), a negative predictive value of 76% (89%) and an AUC of 0.82 (0.88). Comparable results were obtained using the validation dataset. The comprehensive NAFLD score, which includes additional laboratory parameters, has enhanced discrimination ability, with an AUC of 0.86 for males and 0.91 for females. Both simple and comprehensive NAFLD scores were significantly increased in subjects with higher fatty liver grades or severity of liver conditions (e.g., simple steatosis, steatohepatitis). CONCLUSIONS: The new non-laboratory-based self-assessment score may be useful for identifying individuals at high-risk of NAFLD. Further studies are warranted to evaluate the utility and feasibility of the scores in various settings.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Lee, Hyun Chul(이현철)
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
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