Use of a diabetes self-assessment score to predict nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

Gyuri Kim, Yong Ho Lee, Young Min Park, Jungghi Kim, Heesuk Kim, Byung Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee, Dae Jung Kim

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are strongly associated with obesity, insulin resistance, and type 2 diabetes. We recently developed and validated a self-assessment score in the Korean population to identify people at high risk for diabetes. The objective of this study was to evaluate whether the self-assessment risk score for diabetes can also be used to screen for the presence of NAFLD or NASH. The study population included 15,676 subjects (8313 men and 7363 women) over 20 years old who visited the National Health Insurance Service Ilsan Hospital in Korea between 2008 and 2010. Anthropometric, clinical, and laboratory data were analyzed during regular health checkups. Fatty liver disease was diagnosed using ultrasound, discrimination capability was assessed based on the area under the receiver operating characteristic curve (AUC), and evaluation measures, including sensitivity and specificity, were calculated. Multiple logistic analyses were also performed. We calculated a self-assessed risk score for diabetes (range: 0-11), and a cutoff of ≥5 identified 60% (50%) of men (women) at high risk for NAFLD, reflecting a sensitivity of 79% (85%), a specificity of 60% (66%), a positive predictive value (PPV) of 68% (51%), and a negative predictive value (NPV) of 73% (91%), with an AUC of 0.75 (0.82) for men (women). A cutoff point of ≥6 identified 43% (31%) of men (women) at high risk for NASH, reflecting a sensitivity of 80% (86%), a specificity of 64% (75%), a PPV of 30% (28%), and a NPV of 94% (98%), with an AUC of 0.77 (0.86) for men (women). The odds ratios that a 1-point increase in the diabetes risk scores would be associated with an increased risk for NAFLD and NASH were 1.20 [95% confidence interval (CI): 1.16-1.25] and 1.57 (95% CI: 1.49-1.65), respectively, in men, and 1.28 (95% CI: 1.21-1.34) and 1.89 (95% CI: 1.73-2.07), respectively, in women. The present study indicates that our self-assessment risk score for diabetes could be an effective primary screening tool for the presence of NAFLD or NASH.

Original languageEnglish
Pages (from-to)e1103
JournalMedicine (United States)
Volume94
Issue number27
DOIs
Publication statusPublished - 2015 Jul 9

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Confidence Intervals
Area Under Curve
National Health Programs
Self-Assessment
Non-alcoholic Fatty Liver Disease
Fatty Liver
Korea
ROC Curve
Type 2 Diabetes Mellitus
Population
Insulin Resistance
Liver Diseases
Obesity
Odds Ratio
Sensitivity and Specificity
Health

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Kim, Gyuri ; Lee, Yong Ho ; Park, Young Min ; Kim, Jungghi ; Kim, Heesuk ; Lee, Byung Wan ; Kang, Eun Seok ; Cha, Bong Soo ; Lee, Hyun Chul ; Kim, Dae Jung. / Use of a diabetes self-assessment score to predict nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. In: Medicine (United States). 2015 ; Vol. 94, No. 27. pp. e1103.
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Use of a diabetes self-assessment score to predict nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. / Kim, Gyuri; Lee, Yong Ho; Park, Young Min; Kim, Jungghi; Kim, Heesuk; Lee, Byung Wan; Kang, Eun Seok; Cha, Bong Soo; Lee, Hyun Chul; Kim, Dae Jung.

In: Medicine (United States), Vol. 94, No. 27, 09.07.2015, p. e1103.

Research output: Contribution to journalArticle

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T1 - Use of a diabetes self-assessment score to predict nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

AU - Kim, Gyuri

AU - Lee, Yong Ho

AU - Park, Young Min

AU - Kim, Jungghi

AU - Kim, Heesuk

AU - Lee, Byung Wan

AU - Kang, Eun Seok

AU - Cha, Bong Soo

AU - Lee, Hyun Chul

AU - Kim, Dae Jung

PY - 2015/7/9

Y1 - 2015/7/9

N2 - Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are strongly associated with obesity, insulin resistance, and type 2 diabetes. We recently developed and validated a self-assessment score in the Korean population to identify people at high risk for diabetes. The objective of this study was to evaluate whether the self-assessment risk score for diabetes can also be used to screen for the presence of NAFLD or NASH. The study population included 15,676 subjects (8313 men and 7363 women) over 20 years old who visited the National Health Insurance Service Ilsan Hospital in Korea between 2008 and 2010. Anthropometric, clinical, and laboratory data were analyzed during regular health checkups. Fatty liver disease was diagnosed using ultrasound, discrimination capability was assessed based on the area under the receiver operating characteristic curve (AUC), and evaluation measures, including sensitivity and specificity, were calculated. Multiple logistic analyses were also performed. We calculated a self-assessed risk score for diabetes (range: 0-11), and a cutoff of ≥5 identified 60% (50%) of men (women) at high risk for NAFLD, reflecting a sensitivity of 79% (85%), a specificity of 60% (66%), a positive predictive value (PPV) of 68% (51%), and a negative predictive value (NPV) of 73% (91%), with an AUC of 0.75 (0.82) for men (women). A cutoff point of ≥6 identified 43% (31%) of men (women) at high risk for NASH, reflecting a sensitivity of 80% (86%), a specificity of 64% (75%), a PPV of 30% (28%), and a NPV of 94% (98%), with an AUC of 0.77 (0.86) for men (women). The odds ratios that a 1-point increase in the diabetes risk scores would be associated with an increased risk for NAFLD and NASH were 1.20 [95% confidence interval (CI): 1.16-1.25] and 1.57 (95% CI: 1.49-1.65), respectively, in men, and 1.28 (95% CI: 1.21-1.34) and 1.89 (95% CI: 1.73-2.07), respectively, in women. The present study indicates that our self-assessment risk score for diabetes could be an effective primary screening tool for the presence of NAFLD or NASH.

AB - Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are strongly associated with obesity, insulin resistance, and type 2 diabetes. We recently developed and validated a self-assessment score in the Korean population to identify people at high risk for diabetes. The objective of this study was to evaluate whether the self-assessment risk score for diabetes can also be used to screen for the presence of NAFLD or NASH. The study population included 15,676 subjects (8313 men and 7363 women) over 20 years old who visited the National Health Insurance Service Ilsan Hospital in Korea between 2008 and 2010. Anthropometric, clinical, and laboratory data were analyzed during regular health checkups. Fatty liver disease was diagnosed using ultrasound, discrimination capability was assessed based on the area under the receiver operating characteristic curve (AUC), and evaluation measures, including sensitivity and specificity, were calculated. Multiple logistic analyses were also performed. We calculated a self-assessed risk score for diabetes (range: 0-11), and a cutoff of ≥5 identified 60% (50%) of men (women) at high risk for NAFLD, reflecting a sensitivity of 79% (85%), a specificity of 60% (66%), a positive predictive value (PPV) of 68% (51%), and a negative predictive value (NPV) of 73% (91%), with an AUC of 0.75 (0.82) for men (women). A cutoff point of ≥6 identified 43% (31%) of men (women) at high risk for NASH, reflecting a sensitivity of 80% (86%), a specificity of 64% (75%), a PPV of 30% (28%), and a NPV of 94% (98%), with an AUC of 0.77 (0.86) for men (women). The odds ratios that a 1-point increase in the diabetes risk scores would be associated with an increased risk for NAFLD and NASH were 1.20 [95% confidence interval (CI): 1.16-1.25] and 1.57 (95% CI: 1.49-1.65), respectively, in men, and 1.28 (95% CI: 1.21-1.34) and 1.89 (95% CI: 1.73-2.07), respectively, in women. The present study indicates that our self-assessment risk score for diabetes could be an effective primary screening tool for the presence of NAFLD or NASH.

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