Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center Cohorts
Background Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. Type 2 diabetes mellitus (T2DM) is a risk factor that accelerates NAFLD progression, leading to fibrosis and cirrhosis. Thus, here we aimed to develop a simple model to predict the pre...
Main Authors: | , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Academya Publishing Co.
2021-08-01
|
Series: | Endocrinology and Metabolism |
Subjects: | |
Online Access: | http://www.e-enm.org/upload/pdf/enm-2021-1074.pdf |
id |
doaj-d6e79e0e8b6c413f9265ba80be6dff9b |
---|---|
record_format |
Article |
spelling |
doaj-d6e79e0e8b6c413f9265ba80be6dff9b2021-09-03T00:03:20ZengAcademya Publishing Co.Endocrinology and Metabolism2093-596X2093-59782021-08-0136482383410.3803/EnM.2021.10742209Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center CohortsJiwon Kim0Minyoung Lee1Soo Yeon Kim2Ji-Hye Kim3Ji Sun Nam4Sung Wan Chun5Se Eun Park6Kwang Joon Kim7Yong-ho Lee8Joo Young Nam9Eun Seok Kang10 Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Education and Training, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Severance Health Check-up, Severance Hospital, Yonsei University Health System, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, KoreaBackground Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. Type 2 diabetes mellitus (T2DM) is a risk factor that accelerates NAFLD progression, leading to fibrosis and cirrhosis. Thus, here we aimed to develop a simple model to predict the presence of NAFLD based on clinical parameters of patients with T2DM. Methods A total of 698 patients with T2DM who visited five medical centers were included. NAFLD was evaluated using transient elastography. Univariate logistic regression analyses were performed to identify potential contributors to NAFLD, followed by multivariable logistic regression analyses to create the final prediction model for NAFLD. Results Two NAFLD prediction models were developed, with and without serum biomarker use. The non-laboratory model comprised six variables: age, sex, waist circumference, body mass index (BMI), dyslipidemia, and smoking status. For a cutoff value of ≥60, the prediction accuracy was 0.780 (95% confidence interval [CI], 0.743 to 0.817). The second comprehensive model showed an improved discrimination ability of up to 0.815 (95% CI, 0.782 to 0.847) and comprised seven variables: age, sex, waist circumference, BMI, glycated hemoglobin, triglyceride, and alanine aminotransferase to aspartate aminotransferase ratio. Our non-laboratory model showed non-inferiority in the prediction of NAFLD versus previously established models, including serum parameters. Conclusion The new models are simple and user-friendly screening methods that can identify individuals with T2DM who are at high-risk for NAFLD. Additional studies are warranted to validate these new models as useful predictive tools for NAFLD in clinical practice.http://www.e-enm.org/upload/pdf/enm-2021-1074.pdfnon-alcoholic fatty liver diseasediabetes mellitustype 2transient elastographyscreening |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jiwon Kim Minyoung Lee Soo Yeon Kim Ji-Hye Kim Ji Sun Nam Sung Wan Chun Se Eun Park Kwang Joon Kim Yong-ho Lee Joo Young Nam Eun Seok Kang |
spellingShingle |
Jiwon Kim Minyoung Lee Soo Yeon Kim Ji-Hye Kim Ji Sun Nam Sung Wan Chun Se Eun Park Kwang Joon Kim Yong-ho Lee Joo Young Nam Eun Seok Kang Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center Cohorts Endocrinology and Metabolism non-alcoholic fatty liver disease diabetes mellitus type 2 transient elastography screening |
author_facet |
Jiwon Kim Minyoung Lee Soo Yeon Kim Ji-Hye Kim Ji Sun Nam Sung Wan Chun Se Eun Park Kwang Joon Kim Yong-ho Lee Joo Young Nam Eun Seok Kang |
author_sort |
Jiwon Kim |
title |
Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center Cohorts |
title_short |
Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center Cohorts |
title_full |
Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center Cohorts |
title_fullStr |
Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center Cohorts |
title_full_unstemmed |
Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center Cohorts |
title_sort |
non-laboratory-based simple screening model for nonalcoholic fatty liver disease in patients with type 2 diabetes developed using multi-center cohorts |
publisher |
Academya Publishing Co. |
series |
Endocrinology and Metabolism |
issn |
2093-596X 2093-5978 |
publishDate |
2021-08-01 |
description |
Background Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. Type 2 diabetes mellitus (T2DM) is a risk factor that accelerates NAFLD progression, leading to fibrosis and cirrhosis. Thus, here we aimed to develop a simple model to predict the presence of NAFLD based on clinical parameters of patients with T2DM. Methods A total of 698 patients with T2DM who visited five medical centers were included. NAFLD was evaluated using transient elastography. Univariate logistic regression analyses were performed to identify potential contributors to NAFLD, followed by multivariable logistic regression analyses to create the final prediction model for NAFLD. Results Two NAFLD prediction models were developed, with and without serum biomarker use. The non-laboratory model comprised six variables: age, sex, waist circumference, body mass index (BMI), dyslipidemia, and smoking status. For a cutoff value of ≥60, the prediction accuracy was 0.780 (95% confidence interval [CI], 0.743 to 0.817). The second comprehensive model showed an improved discrimination ability of up to 0.815 (95% CI, 0.782 to 0.847) and comprised seven variables: age, sex, waist circumference, BMI, glycated hemoglobin, triglyceride, and alanine aminotransferase to aspartate aminotransferase ratio. Our non-laboratory model showed non-inferiority in the prediction of NAFLD versus previously established models, including serum parameters. Conclusion The new models are simple and user-friendly screening methods that can identify individuals with T2DM who are at high-risk for NAFLD. Additional studies are warranted to validate these new models as useful predictive tools for NAFLD in clinical practice. |
topic |
non-alcoholic fatty liver disease diabetes mellitus type 2 transient elastography screening |
url |
http://www.e-enm.org/upload/pdf/enm-2021-1074.pdf |
work_keys_str_mv |
AT jiwonkim nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts AT minyounglee nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts AT sooyeonkim nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts AT jihyekim nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts AT jisunnam nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts AT sungwanchun nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts AT seeunpark nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts AT kwangjoonkim nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts AT yongholee nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts AT jooyoungnam nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts AT eunseokkang nonlaboratorybasedsimplescreeningmodelfornonalcoholicfattyliverdiseaseinpatientswithtype2diabetesdevelopedusingmulticentercohorts |
_version_ |
1717818253080788992 |