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Predicting Liver Disease Risk Using a Combination of Common Clinical Markers: A Screening Model from Routine Health Check-Up.
Disease Markers Pub Date : 2020-05-31 , DOI: 10.1155/2020/8460883
Yi Wang 1, 2 , Yanni Li 1, 3 , Xiaoyi Wang 1 , Ranko Gacesa 3 , Jie Zhang 1 , Lu Zhou 1, 4 , Bangmao Wang 1
Affiliation  

Background. Early detection is crucial for the prognosis of patients with autoimmune liver disease (AILD). Due to the relatively low incidence, developing screening tools for AILD remain a challenge. Aims. To analyze clinical characteristics of AILD patients at initial presentation and identify clinical markers, which could be useful for disease screening and early detection. Methods. We performed observational retrospective study and analyzed 581 AILD patients who were hospitalized in the gastroenterology department and 1000 healthy controls who were collected from health management center. Baseline characteristics at initial presentation were used to build regression models. The model was validated on an independent cohort of 56 patients with AILD and 100 patients with other liver disorders. Results. Asymptomatic AILD individuals identified by the health check-up are increased yearly (from 31.6% to 68.0%, ). The cirrhotic rates at an initial presentation are decreased in the past 18 years (from 52.6% to 20.0%, ). Eight indicators, which are common in the health check-up, are independent risk factors of AILD. Among them, abdominal lymph node enlargement (LN) positive is the most significant different (OR 8.85, 95% CI 2.73-28.69, ). The combination of these indicators shows high predictive power (, sensitivity 89.0% and specificity 96.4%) for disease screening. Except two liver or cholangetic injury makers, the combination of AGE, GENDER, GLB, LN, concomitant extrahepatic autoimmune diseases, and familial history also shows a high predictive power for AILD in other liver disorders (). Conclusion. Screening for AILD with described parameters can detect AILD in routine health check-up early, effectively and economically. Eight variables in routine health check-up are associated with AILD and the combination of them shows good ability of identifying high-risk individuals.

中文翻译:

使用常见临床标志物的组合预测肝病风险:常规健康检查的筛查模型。

背景。早期发现对于自身免疫性肝病 (AILD) 患者的预后至关重要。由于发病率相对较低,开发 AILD 筛查工具仍然是一个挑战。目标。分析 AILD 患者初次就诊时的临床特征并确定临床标志物,这可能有助于疾病筛查和早期发现。方法. 我们进行了观察性回顾性研究,分析了消化内科住院的581名AILD患者和健康管理中心收集的1000名健康对照者。初始呈现时的基线特征用于建立回归模型。该模型在 56 名 AILD 患者和 100 名其他肝病患者的独立队列中得到验证。结果。通过健康检查发现的无症状 AILD 个体逐年增加(从 31.6% 到 68.0%,)。在过去的 18 年中,首次出现的肝硬化率有所下降(从 52.6% 降至 20.0%,)。体检中常见的八项指标是AILD的独立危险因素。其中,腹部淋巴结肿大(LN)阳性差异最显着(OR 8.85,95% CI 2.73-28.69,)。这些指标的组合显示出很高的预测能力(,敏感性 89.0% 和特异性 96.4%) 用于疾病筛查。除了两个肝脏或胆管损伤因素外,AGE、GENDER、GLB、LN、伴随的肝外自身免疫性疾病和家族史的组合也显示出对其他肝脏疾病的高度预测能力。)。 结论。使用所述参数筛查 AILD 可以在常规健康检查中及早、有效且经济地检测 AILD。常规健康检查中的8个变量与AILD相关,它们的组合显示出良好的识别高危个体的能力。
更新日期:2020-05-31
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