title: Simple scoring system for predicting cirrhosis in nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  To investigate a simple noninvasive scoring system for predicting liver cirrhosis in nonalcoholic fatty liver disease (NAFLD) patients.
  
  
  METHODS
  A total of 1048 patients with liver-biopsy-confirmed NAFLD were enrolled from nine hepatology centers in Japan (stage 0, 216; stage 1, 334; stage 2, 270; stage 3, 190; stage 4, 38). The weight and height of the patients were measured using a calibrated scale after requesting the patients to remove their shoes and any heavy clothing. Venous blood samples were obtained in the morning after the patients had fasted overnight for 12 h. Laboratory evaluation was performed in all patients. Statistical analysis was conducted using SPSS version 12.0. Continuous variables were expressed as mean ± SD.
  
  
  RESULTS
  The optimal cutoff value of platelet count, serum albumin, and aminotransferase/alanine aminotransferase ratio (AAR) was set at < 15.3 10(4)/μL, < 4.0 g/dL, and > 0.9, respectively, by the receiver operating characteristic curve. These three variables were combined in an unweighted sum (platelet count = 1 point, serum albumin = 1 point, AAR = 1 point) to form an easily calculated composite score for predicting cirrhosis in NAFLD patients, called the PLALA (platelet, albumin, AAR) score. The diagnosis of PLALA ≥ 2 had sufficient accuracy for detecting liver cirrhosis in NAFLD patients.
  
  
  CONCLUSIONS
  The PLALA score may be an ideal scoring system for detecting cirrhosis in NAFLD patients with sufficient accuracy and simplicity to be considered for clinical use.
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Takaomi
authors.initials: T
authors.lastname: Kessoku
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Yoneda
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Kento
authors.initials: K
authors.lastname: Imajo
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hyogo
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ono
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Kawaguchi
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Saiyu
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Keizo
authors.initials: K
authors.lastname: Anzai
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Toshiji
authors.initials: T
authors.lastname: Saibara
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Itoh
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.affiliation: Takaomi Kessoku, Yuji Ogawa, Masato Yoneda, Kento Imajo, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016009:Chi-Square Distribution; D004796:Clinical Enzyme Tests; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007564:Japan; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D016017:Odds Ratio; D010976:Platelet Count; D011237:Predictive Value of Tests; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D000075462:Serum Albumin, Human; D012720:Severity of Illness Index
chemical_list: C422455:ALB protein, human; D015415:Biomarkers; D012709:Serum Albumin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000075462:Serum Albumin, Human
keywords: Alanine aminotransferase ratio; Albumin; Cirrhosis; Fibrosis; Nonalcoholic fatty liver disease; Platelet
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