Establishment of a model for evaluating the severity of nonalcoholic fatty liver disease based on transient elastography parameters

Mingjie YAO; Xiajie WEN; Leijie WANG; Qiong HE; Jianwen LUO; Jiangao FAN; Qing XIE; Chengwei CHEN; Qing Chun FU; Jun Ping SHI; Yongfeng YANG; Yun XU; Lungen LU; Fengmin LU

doi:10.3969/j.issn.1001-5256.2021.07.027

Volume 37 Issue 7

Jul. 2021

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Article Navigation > Journal of Clinical Hepatology > 2021 > 37(7): 1614-1618

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Establishment of a model for evaluating the severity of nonalcoholic fatty liver disease based on transient elastography parameters

DOI: 10.3969/j.issn.1001-5256.2021.07.027

1a.
Department of Anatomy and Embryology, School of Basic Medical Sciences, Peking University, Beijing 100191, China
1b.
Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University, Beijing 100191, China
2.
Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
3.
Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
4.
Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
5.
Liver Center, The 905th Hospital of the Chinese People's Liberation Army Nary, Shanghai 200052, China
6.
Department of Hepatology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310014, China
7.
Department of Hepatology, The Second Hospital of Nanjing, Nanjing 210003, China
8.
Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
9.
Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China

Research funding:

National Natural Science Foundation of China Grant (81902115);

National Key Research and Development Program of China (SQ2020YFF0426358);

National Science and Technology Major Project for Infectious Diseases (2017ZX10302201);

National Science and Technology Major Project for Infectious Diseases (2017ZX10202203);

China Postdoctoral Science Foundation (2017M620802);

Beijing Municipal Science & Technology Commission (Z161100000116047)

Received Date: 2020-11-20
Accepted Date: 2021-01-11
Published Date: 2021-07-20

Abstract

Abstract

Objective To establish a model for evaluating the severity of nonalcoholic fatty liver disease (NAFLD) based on a combined analysis of transient elastography parameters. Methods A retrospective analysis was performed for the clinical information and liver elasticity parameters of 184 NAFLD patients who attended 7 hospitals in China from July 2014 to July 2017 and underwent liver biopsy for pathological diagnosis. Liver elasticity parameters were named as P1-P18 according to the amplitude, frequency, dispersion, and attenuation of ultrasound signals. The Spearman rank correlation test and the linear regression analysis were used to establish the models for evaluating steatosis degree, inflammatory activity, and fibrosis degree, and the receiver operating characteristic (ROC) curve was used to evaluate the value of each diagnostic model. Results The ultrasound parameters based on transient elastography were well correlated with steatosis degree, inflammatory activity, and liver fibrosis degree in NAFLD patients. The multivariate analysis showed that P1 and P12 were independent indicators for predicting steatosis degree; P1, P3, P6, and P11 were independent indicators for predicting inflammatory activity; P2 and P3 were significantly correlated with liver fibrosis degree. The model Y=0.013×P1+0.055×P12-0.318 5 for predicting steatosis degree established based on linear regression had an area under the ROC curve (AUC) of 0.895 (95% confidence interval [CI]: 0.842-0.936) and 0.939 (95%CI: 0.894-0.969), respectively, in the diagnosis of mild steatosis and moderate-to-severe steatosis, with a sensitivity of 82.35% and 86.26%, respectively, and a specificity of 89.23% and 93.27%, respectively (P < 0.001). The model Y=0.008×P1+0.030×P3+0.029×P6-1.875×10^-4×P11+0.416 for predicting inflammatory activity had an AUC of 0.828 (95%CI: 0.793-0.865) and 0.874 (95%CI: 0.817-0.918), respectively, in the diagnosis of early-stage inflammation and significant inflammation, with a sensitivity of 70.6% and 73.96%, respectively, and a specificity of 85.7% and 93.33%, respectively (P < 0.001). The model Y=-0.003×P1 + 0.601×(lnP2)+0.285×(lnP3)+0.036×P15 + 0.078 for predicting liver fibrosis degree had an AUC of 0.805 (95%CI: 0.740-0.869), 0.767 (95%CI: 0.699-0.827), and 0.803 (95%CI: 0.701-0.906), respectively, in the diagnosis of significant fibrosis, severe fibrosis, and early liver cirrhosis, with a sensitivity of 72.27%, 77.63%, and 90.00%, respectively, and a specificity of 79.69%, 66.42%, and 66.47%, respectively (P < 0.001). Conclusion Different parameters of transient elastography can effectively reflect steatosis degree, inflammatory activity, and fibrosis degree in NAFLD patients, and a combined model can improve the accuracy of disease severity prediction in NAFLD patients.
- Non-alcoholic Fatty Liver Disease,
- Elasticity Imaging Techniques,
- Models, Statistical

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References(14)

References

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Establishment of a model for evaluating the severity of nonalcoholic fatty liver disease based on transient elastography parameters

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Establishment of a model for evaluating the severity of nonalcoholic fatty liver disease based on transient elastography parameters

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