摘要
Abstract
Objective:To investigate the risk factors for non-alcoholic fatty liver disease(NAFLD)in overweight and obese children and to construct a column-line graphical model to predict the risk of morbidity.Methods:A total of 225 overweight and obese children from our hospital from June 2020 to June 2022 were selected,and the dataset was randomly divided into 70％training set(158 cases)and 30％test set(67 cases)using the retention method.Patients in the training set were divided into a non-NAFLD group(117 cases)and an NAFLD group(41 cases)based on the diagnosis of NAFLD.The clinical data of the two groups in the training set were compared,and the influencing factors of NAFLD were analyzed by multi-factor Logistics regression.The line chart prediction model of the risk of NAFLD in overweight and obese children was constructed,and the effectiveness of the model was evaluated by validating the children.Results:There was no significant difference in baseline data between the training set and verification set(P＞0.05).The waist circumference,body mass index(BMI),triacylglycerol(TG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and insulin resistance index(HOMA-IR)in the non-NAFLD group were lower than those in the NAFLD group,while prolactin(PRL)was higher than that in the NAFLD group(P＜0.05).Logistic regression analysis showed that BMI ≥24 kg/m2,waist circumference≥78 cm,serum ALT≥40 U/L,and HOMA-IR ≥2.8 were independent risk factors for NAFLD,while PRL≥10 μg/L was a protective factor.The risk value of NAFLD in overweight and obese children predicted by the line chart model was 0.93.The ROC curve AUC of the line chart model of the training set and the verification set was 0.805(95％CI:0.786～0.915)and 0.761(95％CI:0.641～0.903),respectively.There was no significant difference in the goodness-of-fit test of the calibration curve Hosmer-Lemeshow(P＞0.05).The clinical decision curve indicated that the model was practical.Conclusion:With the overweight and obese children with higher BMI,higher waist circumference,higher serum ALT levels,higher HOMA-IR levels,and lower PRL levels,the corresponding score of the line chart model increased,the risk of NAFLD increased.The line chart prediction model has good working efficiency,safety and reliability,and strong practicability.关键词
儿童/超重/肥胖/非酒精性脂肪性肝病Key words
children/overweight/obesity/non-alcoholic fatty liver disease分类
医药卫生
