脂肪肝指数在非酒精性脂肪性肝病诊断中的应用价值

目的:通过评估脂肪肝指数(FLI),探讨其对非酒精性脂肪性肝病(NAFLD)的筛查和诊断价值。方法:选取年龄大于40岁的上海嘉定地区常住居民共2 519人,通过问卷调查、体格检查及相关人体测量学和生化学指标检测,综合评估人群代谢状态并计算个体FLI。通过高分辨率超声诊断NAFLD。利用受试者工作特征(ROC)曲线评估FLI对于经超声诊断的NAFLD的预测价值。结果:最终共有2 139名受试者纳入统计分析。FLI作为诊断NAFLD的ROC曲线下面积为0.84,95%可信区间为0.82～0.86。当FLI≥30时,其诊断NAFLD的敏感性和特异性最好,灵敏度和特异度分别达到80.6%和73.8%。结论:FLI对于NAFLD的诊断具有较高的参考价值,适用于大样本流行病学研究及指导NAFLD的早期干预和治疗。

Value of fatty liver index in diagnosis of nonalcoholic fatty liver disease

Objective:To investigate the reliability of fatty liver index(FLI) in the screening and diagnosis of nonalcoholic fatty liver disease(NAFLD).Methods:A cross-sectional survey of 2 519 subjects aged 40 years or older in Jiading community of Shanghai was performed.Collection of sociodemographic characteristics and measurement of anthropometrics were performed by trained and certified clinical staff with the use of standard protocols.FLI was calculated from waist circumference,body mass index(BMI),triglycerides and gamma-glutamyl-transferase.NAFLD was diagnosed by hepatic ultrasonography.The receiver operating characteristics(ROC) curve was used to examine the diagnostic performance of FLI for detecting NAFLD.Results:Among the 2 139 participants in final analysis,the area under ROC curve of FLI was 0.84 95% confidence interval(CI) 0.82-0.86 ] for detecting NAFLD.A threshold of FLI≥30 was selected as the optimal operating point to detect NAFLD in this study,of which the sensitivity and specificity were 80.6% and 73.8%,respectively.Conclusions:FLI is a simple method for the screening and diagnosis of NAFLD.FLI is suitable for large sample epidemiological study and for the guidance of early intervention and treatment of NAFLD.