肝纤维化或肝硬化诊断模型在社区来源代谢相关脂肪性肝病患者中的应用价值OA

Objective To assess the diagnostic performance of established models for liver fibrosis or cirrhosis in community-based patients with metabolic dysfunction-associated fatty liver disease(MAFLD)using the National Health and Nutrition Examination Survey(NHANES)database.Methods Data from the NHANES 2017-2020 cycles were analyzed.Receiver operating characteristic(ROC)curves and restricted cubic spline analyses were employed to compare the applicability and diagnostic performance of 26 diagnostic models,including fibrosis-4 index(FIB-4),aspartate aminotransferase-to-platelet ratio index(APRI),non-alcoholic fatty liver disease fibrosis score(NFS),and Hui score in community-based MAFLD patients.Results A total of 2 521 MAFLD patients were included in the final analysis.For the diagnosis of advanced liver fibrosis,the areas under the ROC curve(AUCs)were 0.595(95%CI:0.576-0.614)for APRI,0.593(95%CI:0.573-0.612)for FIB-4,0.748 for Hui score(95%CI:0.730-0.765),and 0.723(95%CI:0.705-0.741)for NFS.For the diagnosis of cirrhosis,the Hui score achieved an AUC of 0.783(95%CI:0.766-0.800).The AUCs of the remaining 22 models for diagnosing advanced liver fibrosis were all lower than those of the Hui score and NFS,indicating limited diag-nostic value.Similar results were observed in the diagnosis of cirrhosis.Conclusion In the community-based MAFLD population,the Hui score demonstrates high diagnostic value for both advanced liver fibrosis and cirrhosis,with its AUCs significantly higher than those of APRI and FIB-4 models.