title: The NAFL Risk Score: A simple scoring model to predict 4-y risk for non-alcoholic fatty liver.
abstract: BACKGROUND
  Although several risk factors for non-alcoholic fatty liver (NAFL) have been reported, there are few clinical scores that predict its incidence in the long term. We developed and validate a scoring model for individual prediction of 4-y risk for NAFL.
  
  
  METHODS
  Four-year follow-up data of 8226 initially NAFL-free subjects enrolled for an annual physical examination from Wenzhou Medical Center were analyzed. These subjects are randomly split into the training and the validation cohort. Univariate and multivariable logistic regression models were employed for model development. The selected variables were assigned an integer or half-integer risk score proportional to the estimated coefficient from the logistic model. Risk scores were tested in a validation cohort. We also compared the predictive performance of with that of the NAFLD Index by computing the area under the receiver operating characteristic curve (AUROC).
  
  
  RESULTS
  The NAFL Risk Score was developed as 0 to 18 points comprising of BMI, TG×GGT, ALT/AST, LDL-C/HDL-C and UA in both sexes. Comparison of the observed with the estimated incidence of NAFL at both cohorts showed satisfactory precision. In addition, the NAFL Risk Score showed relatively good discriminative power (AUROC=0.739 for males, 0.823 for females) compared with the NAFLD Index (AUROC=0.661 for males, 0.729 for females) in these Chinese subjects.
  
  
  CONCLUSIONS
  We developed and validated the NAFL Risk Score, a new scoring model to predict 4-y risk for NAFL. The NAFL Risk Score may be clinically simple and useful for assessing individual risk for NAFL.
authors.affiliation: Department of Hepatology, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China.
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Zhou
authors.affiliation: Department of Hepatology, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China.
authors.forename: Ji-Na
authors.initials: JN
authors.lastname: Zheng
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Wen-Yue
authors.initials: WY
authors.lastname: Liu
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Institute of Internal Medicine, Catholic University of Rome, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Miele
authors.affiliation: Gastroenterology Area, Fondazione Policlinico Gemelli, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vitale
authors.affiliation: Department of Anesthesiology, Critical Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Sven
authors.initials: S
authors.lastname: Van Poucke
authors.affiliation: Department of Hepatology, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; School of the Second Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China.
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Zou
authors.affiliation: Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: Dan-Hong
authors.initials: DH
authors.lastname: Fang
authors.affiliation: Department of Food Science & Nutrition, Zhejiang University, Hangzhou, China.
authors.forename: Shengrong
authors.initials: S
authors.lastname: Shen
authors.affiliation: Wenzhou Medical Center, Wenzhou People's Hospital, Wenzhou, China.
authors.forename: Dong-Chu
authors.initials: DC
authors.lastname: Zhang
authors.affiliation: Department of Hepatology, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Institute of Hepatology, Wenzhou Medical University, Wenzhou, China. Electronic address: zhengmh@wmu.edu.cn.
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Zheng
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis*; D011379:Prognosis; D018570:Risk Assessment
keywords: General population; Non-alcoholic fatty liver; Prediction model; Risk factors