山西医科大学学报2026，Vol.57Issue(7)：803-813,11.DOI:10.13753/j.issn.1007-6611.2026.07.009
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
Diagnostic value of liver fibrosis or cirrhosis models in community-based patients with metabolic dysfunction-associated fatty liver disease
摘要
Abstract
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.关键词
代谢相关脂肪性肝病/美国国家健康和营养调查/肝纤维化/肝硬化/诊断模型/受试者工作特征曲线Key words
MAFLD/NHANES/liver fibrosis/cirrhosis/diagnostic models/receiver operating characteristic curve分类
医药卫生引用本文复制引用
文夏杰,陈博艺..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[J].山西医科大学学报,2026,57(7):803-813,11.基金项目
北京市自然科学基金项目(7244359) （7244359）
首都医科大学HBV感染、临床治愈与免疫联合实验室青年项目(JL202502) （JL202502）
