한빛사 논문
Jeong-Hoon Leea, Donghee Kimb*, Hwa Jung Kimc,d, Chang-Hoon Leee, Jong In Yangb, Won Kime, Yoon Jun Kima, Jung-Hwan Yoona, Sang-Heon Chob, Myung-Whun Sungb, Hyo-Suk Leea
a Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Republic of Korea
b Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital, Healthcare System Gangnam Center, 39th FL Gangnam Finance Center, 737 Yeoksam-dong, Gangnam-gu, Seoul 135-984, Republic of Korea
c Department of Preventive Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Republic of Korea
d Cancer Center, Asan Medical Center, 388-1 Pungnap-2-dong, Songpa-gu, Seoul 138-736, Republic of Korea
e Department of Internal Medicine, Seoul National University College of Medicine, Seoul Municipal Boramae Hospital, 39 Boramae Road, Dongjak-gu, Seoul 156-707, Republic of Korea
*Corresponding author : Donghee Kim
Abstract
Background/Aims: To optimize management of nonalcoholic fatty liver disease (NAFLD), a simple screening tool is necessary. In this study, we aimed to devise a simple index of NAFLD.
Study: A cross-sectional study with 10,724 health check-up subjects (5362 cases with NAFLD versus ageand sex-matched controls) was conducted. Study subjects were randomly assigned to a derivation cohort or a validation cohort.
Results: Multivariate analysis indicated that high serum alanine aminotransferase (ALT) to serum aspartate aminotransferase (AST) ratio, high body mass index (BMI), and diabetes mellitus were independent risk factors of NAFLD (all P < 0.001). Using these variables, a formula was derived by a logistic regression
model: hepatic steatosis index (HSI) = 8×(ALT/AST ratio) + BMI (+2, if female; +2, if diabetes mellitus). HSI had an area under receiver-operating curve of 0.812 (95% confidence interval, 0.801.0.824). At values of <30.0 or >36.0, HSI ruled out NAFLD with a sensitivity of 93.1%, or detected NAFLD with a specificity of 92.4%, respectively. Of 2692 subjects with HSI <30.0 or >36.0 in the derivation cohort, 2305 (85.6%) were correctly classified. HSI was validated in the subsequent validation cohort.
Conclusion: HSI is a simple, efficient screening tool for NAFLD that may be utilized for selecting individuals for liver ultrasonography and for determining the need for lifestyle modifications.
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