title: Development and validation of a simple index system to predict nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  Abdominal ultrasonography is useful for the detection and diagnosis of nonalcoholic fatty liver disease (NAFLD). The aims of this study were to establish a predictive model for the selection of subjects for abdominal ultrasonography for the diagnosis of NAFLD and to assess validity of the model.
  
  
  METHODS
  The subjects included 901 people who visited the health examination center of the Busan Medical Center. We conducted multiple logistic regression analyses of potential risk factors to identify independent risk factors for NAFLD, and developed an index system.
  
  
  RESULTS
  Four independent risk factors were identified. The index system was developed by assigning 1 clinical scoring point to approximately 0.7 logistic regression coefficients to each factor as follows: alanine aminotransferase/aspartate aminotransferase ratio >1.5 (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.21-4.07; P=0.010), 1 point; γ-glutamyl transpeptidase >50 (OR, 2.15; 95% CI, 1.13-4.07; P=0.019), 1 point; triglyceride >150 mg/dL (OR, 1.92; 95% CI, 1.14-3.24; P=0.015), 1 point; 23 kg/m(2)≤BMI⟨25 kg/m(2) (OR, 3.68; 95% CI, 2.05-6.63; P<0.001), 2 points; and BMI 25 kg/m(2) (OR, 7.65; 95% CI, 4.29-13.62; P<0.001), 3 points. The area under the receiver operating characteristics curve was 0.797 (95% CI, 0.751-0.842), and when 3 points was used as a cut-off value, the sensitivity and specificity were 71.7% and 75.9%, respectively.
  
  
  CONCLUSIONS
  NAFLD can be predicted through the clinical application of the index system established herein. If abdominal ultrasonography is used for high-risk patients, NAFLD will be diagnosed and managed in its early stage.
authors.affiliation: Department of Family Medicine, Busan Medical Center, Busan, Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Park
authors.forename: Jie Hyang
authors.initials: JH
authors.lastname: Lim
authors.forename: Eun Ryoung
authors.initials: ER
authors.lastname: Kwon
authors.forename: Hee Kyoung
authors.initials: HK
authors.lastname: Kim
authors.forename: Myoung Chul
authors.initials: MC
authors.lastname: Jung
authors.forename: Kyoung Hwan
authors.initials: KH
authors.lastname: Seol
authors.forename: Woo Yong
authors.initials: WY
authors.lastname: Noh
authors.forename: Na Eun
authors.initials: NE
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood; D015992:Body Mass Index; D005234:Fatty Liver / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014463:Ultrasonography; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase