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

28 Scopus citations

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 (US)
Article numbere0107584
JournalPLoS One
Volume9
Issue number9
DOIs
StatePublished - Sep 1 2014

ASJC Scopus subject areas

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

Fingerprint Dive into the research topics of 'Non-Laboratory-Based self-Assessment screening score for non-Alcoholic fatty liver disease: Development, validation and comparison with other scores'. Together they form a unique fingerprint.

  • Cite this

    Lee, Y. H., Bang, H., Park, Y. M., Bae, J. C., Lee, B. W., Kang, E. S., Cha, B. S., Lee, H. C., Balkau, B., Lee, W. Y., & Kim, D. J. (2014). Non-Laboratory-Based self-Assessment screening score for non-Alcoholic fatty liver disease: Development, validation and comparison with other scores. PLoS One, 9(9), [e0107584]. https://doi.org/10.1371/journal.pone.0107584