title: The development of a clinical score for the prediction of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease using routine parameters.
abstract: OBJECTIVE
  To develop a clinical score for the prediction of nonalcoholic steatohepatitis (NASH) using routine parameters in patients with nonalcoholic fatty liver disease who had abnormal liver function tests and/or fatty liver detected by ultrasonography.
  
  
  METHODS
  To identify parameters associated with the presence of NASH by evaluating anthropometric characteristics and routine biomarkers of 82 patients with histologically proven NAFLD and to develop a clinical score for predicting NASH according to the area under the curve of receiver operating characteristics (AUC) of parameters.
  
  
  RESULTS
  Four parameters [alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), C-reactive protein (CRP), and apolipoprotein B (ApoB)/apolipoprotein A1 (ApoA1) ratio] were significantly linked to NASH. The AUROCs of ALT, GGT, CRP, and ApoB/ApoA1 ratio for the prediction of NASH were 0.829, 0.892, 0.708, and 0.712, respectively. The AUROC of the combined clinical score for the prediction of NASH was 0.904 (95% CI, 0.885-1.002) at a cut-off of 3.8 points with a sensitivity of 90.2%, specificity of 87.0%, positive predictive value of 88.3%, and negative predictive value of 91.5%.
  
  
  CONCLUSIONS
  In the present study, a clinical score was developed for the noninvasive prediction of NASH; the score was based on a combination of routine biochemical parameters and was useful in distinguishing NASH from NAFLD.
authors.affiliation: Department of Liver Diease, The Affiliated Zhenjiang Third Hospital, Jjiangsu University Faculty of Medicine, Zhenjiang, China. lcmu999@163.com.
authors.forename: Li
authors.initials: L
authors.lastname: Chunming
authors.forename: Sheng
authors.initials: S
authors.lastname: Jianhui
authors.forename: Zhang
authors.initials: Z
authors.lastname: Hongguang
authors.forename: Qiu
authors.initials: Q
authors.lastname: Chunwu
authors.forename: Huang
authors.initials: H
authors.lastname: Xiaoyun
authors.forename: Yang
authors.initials: Y
authors.lastname: Lijun
authors.forename: Yu
authors.initials: Y
authors.lastname: Xuejun
mesh_terms: D000410:Alanine Transaminase / Q000097:blood*; D001055:Apolipoproteins B / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D001055:Apolipoproteins B; D015415:Biomarkers; D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase