Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study

Cosmas Rinaldi A Lesmana,1,2 Levina S Pakasi,1 Sri Inggriani,3 Maria L Aidawati,3 Laurentius A Lesmana1 1Digestive Disease and GI Oncology Centre, Medistra Hospital, 2Department of Internal Medicine, Hepatobiliary Division, Cipto Mangunkusumo Hospital, University of Indonesia, 3Radiology Department,...

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Autores principales:	Lesmana CRA, Pakasi LS, Inggriani S, Aidawati ML, Lesmana LA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/54dfc0a54c1a42debc21eae42b7a8488
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spelling	oai:doaj.org-article:54dfc0a54c1a42debc21eae42b7a84882021-12-02T04:01:59ZDevelopment of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study1178-7007https://doaj.org/article/54dfc0a54c1a42debc21eae42b7a84882015-04-01T00:00:00Zhttp://www.dovepress.com/development-of-non-alcoholic-fatty-liver-disease-scoring-system-among--peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Cosmas Rinaldi A Lesmana,1,2 Levina S Pakasi,1 Sri Inggriani,3 Maria L Aidawati,3 Laurentius A Lesmana1 1Digestive Disease and GI Oncology Centre, Medistra Hospital, 2Department of Internal Medicine, Hepatobiliary Division, Cipto Mangunkusumo Hospital, University of Indonesia, 3Radiology Department, Medistra Hospital, Jakarta, IndonesiaBackground: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the community. However, NAFLD remains undiagnosed in most people with limited access to imaging facilities in most developing countries.Objective: To examine the prevalence of NAFLD and to develop the risk scoring model for predicting the presence of NAFLD among adult medical check-up patients.Method: A large prospective cross-sectional study was conducted among medical check-up patients who underwent transabdominal ultrasound examination between January and December 2013 in Medistra Hospital, Jakarta. Data were obtained from the patients' medical records. Logistic regression analyses were undertaken to identify the best combination of risk factors for predicting fatty liver using the backward (likelihood ratio) approach. The adjusted odds ratio and 95% confidence interval were estimated using the logistic regression coefficient. The prediction model was assessed using the receiver operating characteristic curve and the Hosmer–Lemeshow goodness-of-fit test and was validated on a new, prospective cohort. Statistical analysis was done using SPSS version 17.Results: A total of 1,054 cases was included in this study. Fatty liver was present in 538 (51.0%) patients. Bivariate analyses found associations among fatty liver and several risk factors. Six risk factors were incorporated to build the final prediction model. All scores were summed up to obtain the total score. A probability equation was developed by applying linear regression analysis on the total score. The prediction model had good diagnostic performance with an area under the receiver operating characteristic curve =0.833 (95% confidence interval =0.809–0.857). The Hosmer–Lemeshow goodness-of-fit P-value was 0.232, which indicated the appropriateness of the logistic regression model to predict fatty liver. On the validation set, the scoring system proved to be moderately accurate and can potentially be applied to larger population setting.Conclusion: The presence of fatty liver in NAFLD patients can be predicted using our proposed fatty liver scoring system.Keywords: fatty liver, scoring model, ultrasound, community, developing countries, diagnostic performanceLesmana CRAPakasi LSInggriani SAidawati MLLesmana LADove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2015, Iss default, Pp 213-218 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Lesmana CRA Pakasi LS Inggriani S Aidawati ML Lesmana LA Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study
description	Cosmas Rinaldi A Lesmana,1,2 Levina S Pakasi,1 Sri Inggriani,3 Maria L Aidawati,3 Laurentius A Lesmana1 1Digestive Disease and GI Oncology Centre, Medistra Hospital, 2Department of Internal Medicine, Hepatobiliary Division, Cipto Mangunkusumo Hospital, University of Indonesia, 3Radiology Department, Medistra Hospital, Jakarta, IndonesiaBackground: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the community. However, NAFLD remains undiagnosed in most people with limited access to imaging facilities in most developing countries.Objective: To examine the prevalence of NAFLD and to develop the risk scoring model for predicting the presence of NAFLD among adult medical check-up patients.Method: A large prospective cross-sectional study was conducted among medical check-up patients who underwent transabdominal ultrasound examination between January and December 2013 in Medistra Hospital, Jakarta. Data were obtained from the patients' medical records. Logistic regression analyses were undertaken to identify the best combination of risk factors for predicting fatty liver using the backward (likelihood ratio) approach. The adjusted odds ratio and 95% confidence interval were estimated using the logistic regression coefficient. The prediction model was assessed using the receiver operating characteristic curve and the Hosmer–Lemeshow goodness-of-fit test and was validated on a new, prospective cohort. Statistical analysis was done using SPSS version 17.Results: A total of 1,054 cases was included in this study. Fatty liver was present in 538 (51.0%) patients. Bivariate analyses found associations among fatty liver and several risk factors. Six risk factors were incorporated to build the final prediction model. All scores were summed up to obtain the total score. A probability equation was developed by applying linear regression analysis on the total score. The prediction model had good diagnostic performance with an area under the receiver operating characteristic curve =0.833 (95% confidence interval =0.809–0.857). The Hosmer–Lemeshow goodness-of-fit P-value was 0.232, which indicated the appropriateness of the logistic regression model to predict fatty liver. On the validation set, the scoring system proved to be moderately accurate and can potentially be applied to larger population setting.Conclusion: The presence of fatty liver in NAFLD patients can be predicted using our proposed fatty liver scoring system.Keywords: fatty liver, scoring model, ultrasound, community, developing countries, diagnostic performance
format	article
author	Lesmana CRA Pakasi LS Inggriani S Aidawati ML Lesmana LA
author_facet	Lesmana CRA Pakasi LS Inggriani S Aidawati ML Lesmana LA
author_sort	Lesmana CRA
title	Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study
title_short	Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study
title_full	Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study
title_fullStr	Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study
title_full_unstemmed	Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study
title_sort	development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/54dfc0a54c1a42debc21eae42b7a8488
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Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study

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