Non-Laboratory-Based self-Assessment screening score for non-Alcoholic fatty liver disease: Development, validation and comparison with other scores

Yong Ho 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

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article numbere0107584
JournalPloS one
Volume9
Issue number9
DOIs
Publication statusPublished - 2014 Sep

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fatty liver
Liver
Screening
screening
Fatty Liver
National Health Programs
Area Under Curve
Self-Assessment
Non-alcoholic Fatty Liver Disease
Aptitude
health insurance
Waist Circumference
Health insurance
Korea
menopause
Dyslipidemias
Menopause
waist circumference
hyperlipidemia
Body Mass Index

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Lee, Yong Ho ; Bang, Heejung ; Park, Young Min ; Bae, Ji Cheol ; Lee, Byung Wan ; Kang, Eun Seok ; Cha, Bong Soo ; Lee, Hyun Chul ; Balkau, Beverley ; Lee, Won Young ; Kim, Dae Jung. / Non-Laboratory-Based self-Assessment screening score for non-Alcoholic fatty liver disease : Development, validation and comparison with other scores. In: PloS one. 2014 ; Vol. 9, No. 9.
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abstract = "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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Non-Laboratory-Based self-Assessment screening score for non-Alcoholic fatty liver disease : Development, validation and comparison with other scores. / Lee, Yong Ho; Bang, Heejung; Park, Young Min; Bae, Ji Cheol; Lee, Byung Wan; Kang, Eun Seok; Cha, Bong Soo; Lee, Hyun Chul; Balkau, Beverley; Lee, Won Young; Kim, Dae Jung.

In: PloS one, Vol. 9, No. 9, e0107584, 09.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Non-Laboratory-Based self-Assessment screening score for non-Alcoholic fatty liver disease

T2 - Development, validation and comparison with other scores

AU - Lee, Yong Ho

AU - Bang, Heejung

AU - Park, Young Min

AU - Bae, Ji Cheol

AU - Lee, Byung Wan

AU - Kang, Eun Seok

AU - Cha, Bong Soo

AU - Lee, Hyun Chul

AU - Balkau, Beverley

AU - Lee, Won Young

AU - Kim, Dae Jung

PY - 2014/9

Y1 - 2014/9

N2 - 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.

AB - 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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