The performance of noninvasive indexes of adults in identification of nonalcoholic fatty liver disease in children

Autor: Chao Zheng, Chenwei Wu, Mengte Shi, Jushuang Li, Peining Liu, Xinhe Zhou, Yue Su, Xia Chen
Rok vydání: 2021
Předmět:
Zdroj: Journal of Diabetes. 13:744-753
ISSN: 1753-0407
1753-0393
DOI: 10.1111/1753-0407.13169
Popis: The aim of this study is to evaluate the performance of three existing prediction scores which are applicable to adults for identifying nonalcoholic fatty liver disease (NAFLD) in Chinese children.We used data from routine check-up based medical records of 1845 children to validate the performance of three existing scoring systems including the hepatic steatosis index (HSI), Zhejiang University index (ZJU index), and triglyceride-glucose index (TyG index) in detection of NAFLD in children. Propensity score matching was applied to adjust for potential confounding effects in both training and validation cohorts. The area under the curve (AUC) of the receiver operating characteristic curve analysis was utilized to assess the performance of the three scoring systems.Children with NAFLD had higher scores of HSI, ZJU index, and TyG index when compared with the control group (children without NAFLD). Elevated HSI, ZJU index, and TyG index scores were significantly associated with the presence of pediatric NAFLD since adjusted odds ratio and 95% CI with per interquartile range elevation of the HSI, ZJU index, and TyG index were 32.81 (20.48, 52.55), 26.31 (16.97, 40.79), and 1.83 (1.57, 2.13), respectively. In terms of discrimination of NAFLD in children, the AUC of the HSI, ZJU index, and TyG index depending on the validation cohort were 0.964, 0.960, and 0.769, respectively.The HSI and ZJU index could be appropriate noninvasive biomarkers in distinguishing NAFLD in children from their controls with satisfied accuracy, which would emphasize the clinical and public health policy relevance of pediatric NAFLD. Our findings need to be confirmed by additional longitudinal studies.目的: 探讨现有的三种成人非酒精性脂肪肝非侵入性评价指标在评估儿童及青少年非酒精性脂肪肝(NAFLD)中的诊断价值。 方法: 我们选取1845例在温州医科大学附属第二医院常规体检儿童青少年的体检数据, 验证现有的三种非倾入性评价指标:肝脂肪变性指数(HSI)、浙江大学指数(ZJU指数)和三酰甘油-葡萄糖指数(TyG指数)对儿童青少年NAFLD的识别能力, 对纳入的1845例儿童随机分配为训练集与验证集两个集合, 采用倾向性评分的方法调整混杂因素, 采用受试者工作特征曲线分析的曲线下面积评估三种非倾入性评价指标在诊断儿童青少年NAFLD的诊断能力。 结果: 患有NAFLD的儿童青少年HSI、ZJU指数和TyG指数水平均较对照组(无NAFLD的儿童青少年)明显升高, 差异具有统计学意义, HSI、ZJU指数和TyG指数与NAFLD存在显著相关, 在调整混杂因素后, 三种NAFLD非倾入性评价指标的OR值分别为32.81(20.48,52.55)、26.31(16.97,40.79)和1.83(1.57,2.13)。以NAFLD为因变量进行ROC曲线分析, 结果显示, HSI、ZJU指数、TyG指数对儿童青少年NAFLD均具有良好的预测价值, 三种非倾入性评价指标的曲线下面积分别为0.964、 0.960、0.769。 结论: 在儿童青少年NAFLD的甄别方面, HSI指数、ZJU指数对中国儿童青少年NAFLD具有较高的识别能力, 这可能在儿童青少年NAFLD的临床和公共卫生政策有一定的诊断价值, 我们的研究结果需要进一步的队列研究证实。.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje