基于健康体检人群非酒精性脂肪肝简易筛查工具的研究  

A simple screening tool for non-alcoholic fatty liver disease based on healthy physical examination population

作　　者：刘奕婷[1] 王巍[1] LIU Yiting;WANG Wei(Department of Physical Examination Center,the first Affiliated Hospital,China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院体检中心,沈阳110001

出　　处：《公共卫生与预防医学》2020年第2期28-32,共5页Journal of Public Health and Preventive Medicine

摘　　要：目的设计一个基于中国健康体检人群的非酒精性脂肪肝(NAFLD)的简易筛查工具。方法选取2017年1月至2017年12月在中国医科大学附属第一医院健康体检中心接受体检的人群作为研究对象,共纳入32578人。随机抽取80.00%的样本作为训练集构建筛查模型,计算筛检指数,剩余20.00%作为验证集对模型进行验证。结果逐步Logistic回归分析结果显示,体质指数(BMI)、空腹血糖(FPG)、血清甘油三酯(TG)、天门冬氨酸氨基转移酶/丙氨酸氨基转移酶(AST/ALT)这四项指标纳入进了NAFLD的筛查模型,构建的NAFLD筛检指数=2×BMI+FPG+3×TG-7×(AST/ALT)。该指数在训练集中的受试者工作特征(ROC)曲线下的面积为0.883[95%CI:(0.879~0.887)],在验证集中的ROC曲线下面积为0.888[95%CI:(0.880~0.896)]。结论NAFLD筛检指数作为一个简单有效的筛查工具,可以用于大规模人群的普筛,具有一定的流行病学和卫生经济学意义。Objective To design a simple screening tool for non-alcoholic fatty liver disease based on Chinese healthy physical examination population.Methods Subjects were selected from the health management center of China Medical University since January 2017 to December 2017.A total of 32578 subjects were included.80%subjects were randomly selected as the training set for modeling and internal assessment,and the remaining 20%subjects were used as the verification set for external assessment.Stepwise logistic regression analysis was used to construct the NAFLD screening index.Results Multivariate regression analysis showed that body mass index(BMI),fasting glucose(FPG),serum triglyceride(TG),and aspartate aminotransferase/alanine aminotransferase(AST/ALT)were included in the NAFLD screening model.The constructed NAFLD screening index was 2×BMI+FPG+3×TG-7×(AST/ALT).The AUC of the index was 0.883[95%CI(0.879~0.887)]in the training set and was 0.888[95%CI(0.880~0.896)]in the verification set.Conclusion The NAFLD screening index,as a simple and effective screening tool,can be used to screen large-scale population at high risk,which has certain epidemiological and health economic significance.

关 键 词：非酒精性脂肪肝 筛检指数 健康体检人群 

分 类 号：R115[医药卫生—公共卫生与预防医学]