ABSTRACT
AIM: To determine the discriminatory performance of fatty liver index (FLI) for non-alcoholic fatty liver disease (NAFLD). METHODS: The data of 5052 subjects aged over 18 years were analyzed. FLI was calculated from body mass index, waist circumference (WC), triglyceride, and gamma glutamyl transferase data. Logistic regression analysis was conducted to determine the association between FLI and NAFLD. The discriminatory performance of FLI in the diagnosis of NAFLD was evaluated by receiver operating characteristic analysis. Area under the curves (AUCs) and related confidence intervals were estimated. Optimal cutoff points of FLI in the diagnosis of NAFLD were determined based on the maximum values of Youden's index. RESULTS: The mean age of men and women in the study population were 44.8 ± 16.8 and 43.78 ± 15.43, respectively (P = 0.0216). The prevalence of NAFLD was 40.1% in men and 44.2% in women (P < 0.0017). FLI was strongly associated with NAFLD, so that even a one unit increase in FLI increased the chance of developing NAFLD by 5.8% (OR = 1.058, 95%CI: 1.054-1.063, P < 0.0001). Although FLI showed good performance in the diagnosis of NAFLD (AUC = 0.8656 (95%CI: 0.8548-0.8764), there was no significant difference with regards to WC (AUC = 0.8533, 95%CI: 0.8419-0.8646). The performance of FLI was not significantly different between men (AUC = 0.8648, 95%CI: 0.8505-0.8791) and women (AUC = 0.8682, 95%CI: 0.8513-0.8851). The highest performance with regards to age was related to the 18-39 age group (AUC = 0.8930, 95%CI: 0.8766-0.9093). The optimal cutoff points of FLI were 46.9 in men (sensitivity = 0.8242, specificity = 0.7687, Youden's index = 0.5929) and 53.8 in women (sensitivity = 0.8233, specificity = 0.7655, Youden's index = 0.5888). CONCLUSION: Although FLI had acceptable discriminatory power in the diagnosis of NAFLD, WC was a simpler and more accessible index with a similar performance.
Subject(s)
Clinical Enzyme Tests , Liver/enzymology , Non-alcoholic Fatty Liver Disease/diagnosis , Obesity/diagnosis , Triglycerides/blood , Waist Circumference , gamma-Glutamyltransferase/blood , Adolescent , Adult , Aged , Aged, 80 and over , Area Under Curve , Biomarkers/blood , Body Mass Index , Child , Female , Humans , Iran/epidemiology , Logistic Models , Male , Middle Aged , Multivariate Analysis , Non-alcoholic Fatty Liver Disease/blood , Non-alcoholic Fatty Liver Disease/epidemiology , Obesity/blood , Obesity/epidemiology , Odds Ratio , Predictive Value of Tests , Prevalence , Proportional Hazards Models , ROC Curve , Risk Assessment , Risk Factors , Young AdultABSTRACT
BACKGROUND: Cholelithiasis is one of the most prevalent gastrointestinal disorders requiring hospitalization. While different factors influence gallstone formation in patients, these factors are not the same in different societies or in different geographical locations. AIM: To evaluate the epidemiology and risk factors associated with gallstone formation in a large population group, the present survey was conducted in northern Iran. METHODS: In 6143 asymptomatic subjects, the incidence of gallstone formation as well as risk factors were evaluated through a structured questionnaire, physical examination and ultrasonography study. Sample selection was based on stratified cluster systemic randomization. RESULTS: Of these enrolled subjects 3507 (57.1%) were male and 2636 (42.9%) were female with a mean age of 42.71 ± 17.1 years. The prevalence of gallstones was 0.80%. On multivariate analysis, the risk of gallstone disease is correlated to rural locale, diastolic hypertension, age, and TG levels. However, systolic hypertension, glucose serum levels and obesity were also significantly associated with the presence of gallstones. CONCLUSION: The present study proposes that the rate of gallstone disease in northern Iran is lower than previous studies have reported, and that most of the risk factors can be prevented by changes in lifestyle and diet.
