Risk factors analysis and modeling prediction of non-alcoholic fatty liver disease in asymptomatic young adults (青年无症状体检人群非酒精性脂肪肝危险因素分析及建模预测)

Abstract

Objective To explore the risk factors of non-alcoholic fatty liver disease (NAFLD) in young adults and to establish a model for prediction, in order to provide reference for the early prevention of the disease in young people. Methods A retrospective analysis was performed on the young adults who underwent routine physical examination in the Department of Physical Examination from January 2018 to June 2022. Totally 365 adults with NAFLD were divided into the NAFLD group(observation group), and 273 healthy adults were divided into the Healthy group (control group). The differences in general information and blood drawing results between the two groups were analyzed. Results The proportion of male, smoking and hypertension in the NAFLD group was significantly higher than that in the Healthy group; The mean values of BMI and low density lipoprotein-cholesterol in the NAFLD group were significantly higher than those in the Healthy group; The median values of triglyceride, total cholesterol, uric acid, alanine aminotransferase, aspartate aminotransferase and glycosylated hemoglobin in the NAFLD group were higher than those in the Healthy group, with significant difference(P＜0. 05). Multivariate regression analysis showed that BMI increased (OR=1. 429; 95%CI=1. 306～1. 563; P=0. 001), triglyceride (OR=1. 524; 95%CI=1. 086～2. 137; P=0. 015), serum uric acid (OR=1. 005; 95%CI=1. 001~1. 008; P=0. 019), alanine aminotransferase (OR=1. 049; 95%CI=1. 026~1. 071; P=0. 001), aspartate aminotransferase (OR=0. 986; 95%CI = 0. 972～0. 999; P=0. 038), glycosylated hemoglobin (OR=7. 800; 95%CI=3. 666～16. 597; P=0. 001) were independent risk factors for NAFLD(P<0. 05). The six risk factors of non-alcoholic fatty liver disease were modulated: ［PRE curve=BMI×0. 883＋triglyceride×0. 805＋uric acid×0. 710＋alanine aminotransferase×0. 789＋aspartate aminotransferase×0. 671+glycosylated hemoglobin×0. 764］. The area under the curve of the final model was 0. 930 (95%CI: 0. 911 to 0. 949, P<0. 001), the sensitivity was 91. 5%, and the specificity was 80. 6%. Conclusion BMI, triglyceride, uric acid, alanine aminotransferase, aspartate aminotransferase and glycosylated hemoglobin are independent risk factors for non-alcoholic fatty liver disease in young people, and the establishment of a model has good predictive value. (目的 探讨青年人群非酒精性脂肪肝病(NAFLD)相关危险因素及建立模型预测, 以期为青年人群疾病早期预防提供参考。方法 回顾性分析2018年1月—2022年6月在北京中医药大学东方医院体检科行常规体检的青年人群。根据体检结果, 其中NAFLD体检人群365例纳入NAFLD组(观察组), 健康人体检人群273例纳入组健康人组(对照组), 分析两组人群的一般资料、抽血结果等的差异。结果 NAFLD组中男性、吸烟、高血压占比显著高于健康人组; NAFLD组中体质指数(BMI)、低密度脂蛋白-胆固醇等的平均数显著高于健康人组; NAFLD组中甘油三酯、总胆固醇、尿酸、谷丙转氨酶、谷草转氨酶、糖化血红蛋白等的变量中位数高于健康人组, 差异均有统计学意义(P＜0. 05)。多因素回归分析显示, BMI水平升高(OR=1. 429; 95%CI=1. 306～1. 563; P=0. 001)、甘油三酯(OR=1. 524; 95%CI=1. 086~2. 137; P=0. 015)、血尿酸(OR=1. 005; 95%CI=1. 001～1. 008; P=0. 019)、谷丙转氨酶(OR=1. 049; 95%CI=1. 026～1. 071; P=0. 001)、谷草转氨酶(OR=0. 986; 95%CI=0. 972~0. 999; p=0. 038)、糖化血红蛋白(OR=7. 800; 95%CI=3. 666～16. 597; P=0. 001)是NAFLD独立危险因素。将NAFLD的6个危险因素进行造模: 回归模型预测概率(PRE)曲线=BMI×0. 883+甘油三酯×0. 805+血尿酸×0. 710+谷丙转氨酶×0. 789+谷草转氨酶×0. 671+糖化血红蛋白×0. 764。采用ROC曲线进行评估, 最终模型的曲线下面积为0. 930(95%CI: 0. 911~0. 949, P＜0. 001), 敏感度91. 5%, 特异性80. 6%。结论 BMI、甘油三酯、血尿酸、谷丙转氨酶、谷草转氨酶、糖化血红蛋白为青年人群NAFLD独立危险因素, 且建立模型有较好预测价值。)

Keywords

• non-alcoholic fatty liver disease
• physical examination
• prediction
• young adults
• triglycerides
• 非酒精性脂肪肝病
• 体检
• 预测
• 青年人群
• 甘油三酯