Serum Glycocholic Acid-to-Total Bile Acid Ratio Is Independently Associated with Nonalcoholic Fatty Liver Disease: A Retrospective Cross-Sectional Study

Introduction and Aims. Bile acids play an essential role in the progression of nonalcoholic fatty liver disease (NAFLD). This study was aimed at investigating the association of the serum glycocholic acid- (GCA-) to-total bile acid (TBA) ratio with NAFLD in the general population. Materials and Methods. A total of 6708 subjects (2859 cases with NAFLD and 3849 controls) were enrolled in the development cohort and additional 1568 subjects (784 cases with NAFLD and 784 controls) in an independent validation cohort. Demographic characteristics and biochemical data were compared between subjects with NAFLD and controls. Multivariate logistic regression analysis was performed to determine the association of the GCA-to-TBA ratio with NAFLD. A novel model incorporating the GCA-to-TBA ratio was developed for screening NAFLD from the general population. Results. The serum TBA and GCA levels were significantly higher in subjects with NAFLD than in those without NAFLD (2.8 (2.0-4.2) μmol/L vs. 2.5 (1.8-3.7) μmol/L and 1.30 (1.10-1.53) μg/mL vs. 1.28 (1.08-1.50) μg/mL, respectively, all p ≤ 0.01 ), whereas the serum GCA-to-TBA ratio was significantly lower in subjects with NAFLD than in subjects without NAFLD (0.44 (0.33-0.60) vs. 0.48 (0.36-0.64), p ≤ 0.01 ). Logistic regression analysis showed that the GCA-to-TBA ratio was independently associated with NAFLD after adjustment for confounding factors (odds ratio: 0.81, 95% confidence interval (CI): 0.71-0.92, p ≤ 0.01 ). The area under the receiver operating characteristic curve of the novel developed GCA-to-TBA ratio score model in discriminating NAFLD was 0.84 (95% CI: 0.83-0.85) in the development cohort and was 0.91 (95% CI: 0.36-0.65) in the validation cohort. Conclusion. The serum GCA-to-TBA ratio is independently associated with NAFLD. A simple novel model incorporating the GCA-to-TBA ratio score has a good performance in discriminating NAFLD from the general population.

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Nonalcoholic Fatty Liver Disease as a Risk Factor for Prolonged Corrected QT Interval in Apparently Healthy Korean Women

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-713 ◽

2020 ◽

Vol 29 (1) ◽

pp. 59-64

Author(s):

Tae-Ha Chung ◽

Jae-Yong Shim ◽

Yong-Jae Lee

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Liver Disease ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Fatty Liver Disease ◽

Qtc Interval ◽

Korean Women ◽

Nonalcoholic Fatty Liver ◽

Apparently Healthy

Background and Aims: Nonalcoholic fatty liver disease (NAFLD) is clinically important because of its association with an increased risk of sudden cardiac death as well as liver-related mortality. Most cases of sudden cardiac death could be mediated by an arrhythmogenic process. Thus, we aimed to determine the association between NAFLD and corrected QT (QTc) interval in apparently healthy Korean women. Methods: This cross-sectional study included 764 women aged 20 to 74 years old who underwent a health examination program between 2014 and 2015. The QTc interval was calculated using Bazett’s formula (QTc = QT/√RR). Multiple linear and logistic regression analysis were performed to assess independent relationships between NAFLD and QTc interval and prolonged QTc (≥ 450 milliseconds) was calculated after adjusting for confounding variables. Results: The overall prevalence of NAFLD was 23.5% in general healthy women. The standardized β coefficient (95% confidence interval) of the QTc increment in patients with NAFLD was 6.4 milliseconds (1.2–11.8) through multiple linear regression analysis after adjusting for age, body mass index, smoking status, and regular exercise as well as mean arterial pressure, fasting plasma glucose, triglycerides, high-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, calcium, potassium levels and menopause status. Similarly, the odds ratio (95% confidence interval) of NAFLD for prolonged QTc was 2.05 (1.13–3.71) according to multiple logistic regression analysis after adjusting for the same covariables in women aged 20 to 74 years old. Conclusion: We demonstrated the arrhythmogenic potential of NAFLD, implying that careful monitoring of patient electrocardiograms is necessary to evaluate the possible arrhythmic risk in general healthy women with NAFLD.

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Role of Body Mass Index, Waist-to-Height and Waist-to-Hip Ratio in Prediction of Nonalcoholic Fatty Liver Disease

Gastroenterology Research and Practice ◽

10.1155/2012/362147 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 26

Author(s):

Rui-Dan Zheng ◽

Zhuo-Ran Chen ◽

Jian-Neng Chen ◽

Yan-Hui Lu ◽

Jie Chen

Keyword(s):

Body Mass Index ◽

Logistic Regression ◽

Regression Analysis ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Control Group ◽

Nonalcoholic Fatty Liver ◽

Waist To Hip Ratio

Objective.To investigate the anthropometric indicators that can effectively predict the nonalcoholic fatty liver disease (NAFLD).Methods.The height, body weight, waist and hip circumference were measured, and body mass index (BMI), waist-to-height (WHtR) and waist-to-hip ratio (WHR) were calculated. M-H chi square test, logistic regression analysis, and receiver-operating characteristic (ROC) curve were employed for the analysis of risk factors.Patients or Materials.490 patients were recruited, of whom 250 were diagnosed as NAFLD and 240 as non-NAFLD (control group).Results.Compared with the control group, the BMI, WHR, and WHtR were significantly higher in patients with NAFLD. Logistic regression analysis showed that BMI and WHR were effective prognostic factors of NAFLD. In addition, WHR plays a more important role in prediction of NAFLD by the area under curve.Conclusion.WHR is closely related to the occurrence of NAFLD. We assume that WHR is beneficial for the diagnosis NAFLD.

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Development and Validation of a Novel Scoring System for Noninvasive Nonalcoholic Steatohepatitis Detection in Bariatric Patients

Obesity Facts ◽

10.1159/000517383 ◽

2021 ◽

pp. 1-11

Author(s):

Adrian T. Billeter ◽

Sarah Wloka ◽

Rouven Behnisch ◽

Thomas Albrecht ◽

Stephanie Roessler ◽

...

Keyword(s):

Logistic Regression ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Steatohepatitis ◽

Scoring System ◽

Fatty Liver Disease ◽

Validation Cohort ◽

Stepwise Logistic Regression ◽

Obese Patients ◽

Nonalcoholic Fatty Liver

Introduction: Nonalcoholic fatty liver disease covers a broad spectrum. Simple steatosis has usually a benign course while nonalcoholic steatohepatitis (NASH) can progress into hepatocellular carcinoma, and cirrhosis. Therefore, differentiating patients with benign steatosis and NASH is crucial. Liver biopsy, the usual gold standard for NASH diagnosis, cannot be used as a screening method due to its associated risks. This is especially problematic for obese patients with a prevalence of nonalcoholic fatty liver disease (NAFLD) in >80% of patients. The aim of this study was therefore to develop and validate a noninvasive NASH screening test in a cohort of high-risk, morbidly obese patients. Methods: This prospective study examined diagnostic accuracy in accordance with STARD guidelines. 112 liver biopsies were consecutively assigned to either a training or validation cohort. Using the Bedossa histological scoring system, the cohorts were subdivided into NASH versus NAFLD/No NAFLD. Predictors of NASH were evaluated with receiver operating characteristic (ROC) curves. A model was then constructed using a backward stepwise logistic regression and evaluated in an independent validation cohort. Results: 53.5% of the patients had NASH and 4 patients had cirrhosis. Mean body mass index (BMI) was 49.8 ± 7.5 kg/m2. Backward stepwise logistic regression identified 4 parameters associated with the presence of NASH: alanin-aminotransferase, albumin, BMI, and triglycerides. The noninvasive NASH detection score (NI-NASH-DS) had an ROC of 0.851 and 0.727 in the training and validation cohorts, respectively. Sensitivity and specificity were 77.1% and 88% in the training cohort and 88% and 48% in the validation cohort which was much better than the established noninvasive scores. Discussion/Conclusion: The NI-NASH-DS is easy-to-use, inexpensive, and noninvasive and can reliably detect NASH in patients with morbid obesity. Due to its simplicity, it can be used frequently and repeatedly.

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The association between NAFLD and risk of chronic kidney disease: a cross-sectional study

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211048649 ◽

2021 ◽

Vol 12 ◽

pp. 204062232110486

Author(s):

Ying Cao ◽

You Deng ◽

Jingjing Wang ◽

Hong Zhao ◽

Jingyu Zhang ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Logistic Regression ◽

Regression Analysis ◽

Kidney Disease ◽

Liver Fibrosis ◽

Logistic Regression Analysis ◽

Abdominal Ultrasonography ◽

Cross Sectional ◽

Nonalcoholic Fatty Liver ◽

Nafld Fibrosis Score

Objective: The aim of this study was to evaluate the association between nonalcoholic fatty liver disease (NAFLD) and NAFLD with different comorbidities and risk of chronic kidney disease (CKD) and abnormal albuminuria. Materials and Methods: A total of 3872 Chinese individuals excluding those with hepatitis B or C infection and absence of alcohol abuse were included in the study. NAFLD was diagnosed by abdominal ultrasonography. The liver fibrosis was assessed by NAFLD fibrosis score (NFS) and fibrosis-4 index (FIB-4). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or abnormal albuminuria (urinary albumin-to-creatinine ratio ⩾ 3 mg/mmol). The logistic regression analysis was performed to examine the association between NAFLD and NAFLD with different comorbidities and risk of CKD. Results: The prevalence of CKD and abnormal albuminuria was higher in individuals with NAFLD than in those without NAFLD (15.8% vs 11.9%, p < 0.001; 14.8% vs 11.0%, p < 0.001). Logistic regression analysis demonstrated that NAFLD was risk factor of CKD. Notably, after adjustment for sex, age, and DM, NAFLD was associated with 1.31-fold higher risk of prevalent CKD ⩾ 1 ( p < 0.05). NAFLD individuals with elder age, DM, obesity, hypertension, MetS, and advanced liver fibrosis had higher risks of both prevalent CKD and abnormal albuminuria than those without comorbidities. Conclusions: NAFLD and NAFLD with traditional comorbidities are strongly associated with risk of prevalence of CKD and abnormal albuminuria. Patients with NAFLD especially those with coexisting comorbidities were recommended to carefully access the development of CKD.

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A novel procalcitonin-based score for detecting sepsis among critically ill patients

PLoS ONE ◽

10.1371/journal.pone.0245748 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245748

Author(s):

Tung-Lin Tsui ◽

Ya-Ting Huang ◽

Wei-Chih Kan ◽

Mao-Sheng Huang ◽

Min-Yu Lai ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Critically Ill ◽

Critically Ill Patients ◽

Validation Cohort ◽

Multivariate Logistic Regression Analysis ◽

Sepsis Group ◽

C Reactive Protein ◽

Multivariate Logistic Regression ◽

Reactive Protein

Background Procalcitonin (PCT) has been widely investigated as an infection biomarker. The study aimed to prove that serum PCT, combining with other relevant variables, has an even better sepsis-detecting ability in critically ill patients. Methods We conducted a retrospective cohort study in a regional teaching hospital enrolling eligible patients admitted to intensive care units (ICU) between July 1, 2016, and December 31, 2016, and followed them until March 31, 2017. The primary outcome measurement was the occurrence of sepsis. We used multivariate logistic regression analysis to determine the independent factors for sepsis and constructed a novel PCT-based score containing these factors. The area under the receiver operating characteristics curve (AUROC) was applied to evaluate sepsis-detecting abilities. Finally, we validated the score using a validation cohort. Results A total of 258 critically ill patients (70.9±16.3 years; 55.4% man) were enrolled in the derivation cohort and further subgrouped into the sepsis group (n = 115) and the non-sepsis group (n = 143). By using the multivariate logistic regression analysis, we disclosed five independent factors for detecting sepsis, namely, “serum PCT level,” “albumin level” and “neutrophil-lymphocyte ratio” at ICU admission, along with “diabetes mellitus,” and “with vasopressor.” We subsequently constructed a PCT-based score containing the five weighted factors. The PCT-based score performed well in detecting sepsis with the cut-points of 8 points (AUROC 0.80; 95% confidence interval (CI) 0.74–0.85; sensitivity 0.70; specificity 0.76), which was better than PCT alone, C-reactive protein and infection probability score. The findings were confirmed using an independent validation cohort (n = 72, 69.2±16.7 years, 62.5% men) (cut-point: 8 points; AUROC, 0.79; 95% CI 0.69–0.90; sensitivity 0.64; specificity 0.87). Conclusions We proposed a novel PCT-based score that performs better in detecting sepsis than serum PCT levels alone, C-reactive protein, and infection probability score.

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Perceived discrimination and psychotic experiences in the English general population

European Psychiatry ◽

10.1016/j.eurpsy.2019.08.004 ◽

2019 ◽

Vol 62 ◽

pp. 50-57

Author(s):

Andrew Stickley ◽

Hans Oh ◽

Tomiki Sumiyoshi ◽

Zui Narita ◽

Jordan E. DeVylder ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Sexual Orientation ◽

General Population ◽

Logistic Regression Analysis ◽

Perceived Discrimination ◽

Auditory Hallucination ◽

Psychiatric Morbidity ◽

Multivariable Logistic Regression Analysis ◽

Psychotic Experiences

Abstract Background: Perceived discrimination has been linked to psychotic experiences (PEs). However, as yet, information is lacking on the relationship between different forms of discrimination and PEs. This study examined this association in the English general population. Methods: Nationally representative, cross-sectional data were analyzed from 7363 adults aged 16 and above that came from the Adult Psychiatric Morbidity Survey, 2007. Self-reported information was obtained on six forms of discrimination (ethnicity, sex, religious beliefs, age, physical health problems/disability, sexual orientation), while PEs were assessed with the Psychosis Screening Questionnaire (PSQ). Multivariable logistic regression analysis was used to assess associations. Results: In a fully adjusted logistic regression analysis, any discrimination was significantly associated with PEs (odds ratio [OR]: 2.47, 95% confidence interval [CI]: 1.75–3.48). All individual forms of discrimination were significantly associated with PEs except sexual orientation. Multiple forms of discrimination were associated with higher odds for PEs in a monotonic fashion with those experiencing ≥ 3 forms of discrimination having over 5 times higher odds for any PE. In addition, experiencing any discrimination was associated with significantly increased odds for all individual forms of PE with ORs ranging from 2.16 (95%CI: 1.40–3.35) for strange experience to 3.36 (95%CI: 1.47–7.76) for auditory hallucination. Conclusion: Different forms of discrimination are associated with PEs in the general population. As discrimination is common at the societal level, this highlights the importance of public policy and evidence-based interventions to reduce discrimination and improve population mental health.

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Serum SHBG Is Associated With the Development and Regression of Nonalcoholic Fatty Liver Disease: A Prospective Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz244 ◽

2019 ◽

Vol 105 (3) ◽

pp. e791-e804

Author(s):

Xu Wang ◽

Jiewen Xie ◽

Juan Pang ◽

Hanyue Zhang ◽

Xu Chen ◽

...

Keyword(s):

Logistic Regression ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Prediction Models ◽

Stepwise Logistic Regression ◽

Stepwise Logistic Regression Analysis ◽

Nonalcoholic Fatty Liver ◽

Potential Biomarker

Abstract Context SHBG, a homodimeric glycoprotein produced by hepatocytes has been shown to be associated with metabolic disorders. Whether circulating SHBG levels are predictive of later risk of nonalcoholic fatty liver disease (NAFLD) remains unknown. In this study, we prospectively investigated the association between SHBG and NAFLD progression through a community-based cohort comprising 3389 Chinese adults. Methods NAFLD was diagnosed using abdominal ultrasonography. Serum SHBG levels were measured by chemiluminescent enzyme immunometric assay, and their relationship with NAFLD development and regression was investigated after a mean follow-up of 3.09 years using multivariable logistic regression. Results Basal SHBG was negatively associated with NAFLD development, with a fully adjusted odds ratio (OR) and its 95% confidence interval (CI) of 0.22 (0.12-0.40) (P < .001). In contrast, basal SHBG was positively associated with NAFLD regression, with a fully adjusted OR of 4.83 (2.38-9.81) (P < .001). Multiple-stepwise logistic regression analysis showed that SHBG concentration was an independent predictor of NAFLD development (OR, 0.28 [0.18-0.45]; P < .001) and regression (OR, 3.89 [2.43-6.22]; P < .001). In addition, the area under the receiver operating characteristic curves were 0.764 (95% CI, 0.740-0.787) and 0.762 (95% CI, 0.738-0.785) for the prediction models of NAFLD development and regression, respectively. Conclusions Serum SHBG concentration is associated with the development and regression of NAFLD; moreover, it can be a potential biomarker for predicting NAFLD progression, and also a novel preventive and therapeutic target for NAFLD.

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