摘要
目的:针对非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)人群开发一个基于血清学标志物预测显著肝纤维化的模型。方法:选择来自美国国家健康与营养调查(National Health and Nutrition Examination Survey,NHANES)数据库的2543例NAFLD患者,以7∶3的比例将人群随机分为训练集和内部验证集,采用SPSS 26.0对训练集和验证集的各项指标进行卡方检验、单因素分析以及二元Logistic回归分析(逐步分析),得到预测模型,再在R 4.3.1中进行模型的评价及验证。结果:年龄、性别、臀围、铁蛋白、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、γ-谷氨酰转移酶(gamma-glutamyl transferase,GGT)、心脏代谢指数(cardiometabolic index,CMI)是NAFLD患者发生显著肝纤维化的独立危险因素;预测模型aCHANGE在训练集和验证集都有良好的表现,其在训练集的受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积(area under curve,AUC)为0.775,在验证集的AUC为0.775,校准曲线、决策曲线分析(decision curve analysis,DCA)结果均良好。结论:a CHANGE模型有助于预测NAFLD患者出现肝脏显著纤维化的风险。
Objective:To develop a predictive model for significant liver fibrosis based on serological markers in the population with non-alcoholic fatty liver disease(NAFLD).Methods:A total of 2543 NAFLD patients from the he National Health and Nutrition Examination Survey(NHANES)database in the United States were selected.These patients were randomly divided into a training set and an internal validation set in a 7∶3 ratio.Chi-square tests,univariate analysis,and binary logistic regression analysis(stepwise)were performed on both sets using SPSS 26.0,followed by model evaluation and validation in R 4.3.1.Results:Age,gender,hip circumference,ferritin,aspartate aminotransferase(AST),gamma-glutamyl transferase(GGT),and cardiometabolic index(CMI)were identified as independent risk factor for significant liver fibrosis in NAFLD patients,respectively the predictive model aCHANGE demonstrated good performance in both the training and validation sets,with an area under the curve(AUC)of the receiver operating characteristic(ROC)curve of 0.775 in both sets.The calibration curves and decision curve analysis(DCA)also showed good results.Conclusion:The aCHANGE model is useful for predicting the risk of significant liver fibrosis in NAFLD patients.
作者
方泽桂
董莉
史陆宸
姜楠
蒋龙凤
朱传龙
李军
FANG Zegui;DONG Li;SHI Luchen;JIANG Nan;JIANG Longfeng;ZHU Chuanlong;LI Jun*(Department of Infectious Diseases,the First Affiliated Hospital of Nanjing Medical University,Nanjing 211166,China)
出处
《南京医科大学学报（自然科学版）》
CAS
北大核心
2024年第8期1092-1099,共8页
Journal of Nanjing Medical University(Natural Sciences)
基金
国家自然科学基金(81871242)。
关键词
非酒精性脂肪性肝病
显著肝纤维化
预测模型
non-alcoholic fatty liver disease
significant liver fibrosis
prediction model
