Development and Validation of a Nomogram for Prediction of the Risk of MAFLD in an Overweight and Obese Population

Abstract

Background and Aims: Metabolic associated fatty liver disease (MAFLD) is a serious condition, and a simple method is needed for practitioners to identify patients with the disease and have a high risk of disease progression. Methods: We developed and validated a nomogram for fatty liver disease and reclassified the risk factors for MAFLD. The development cohort had 335 patients who received bioelectrical impedance analysis and liver ultrasound attenuation measurements at Shenzhen People's Hospital between September 2020 and June 2021. The validation cohort had 200 patients from other hospitals who received the same evaluation. A random forest procedure and binary logistic analysis were used to screen for risk factors, establish a fatty liver disease predictive model, and forecast the risk of MAFLD. The performance of the nomogram was evaluated by measurement of discrimination, calibration, and clinical usefulness. Results: The nomogram provided good predictions in a model that included body mass index (BMI) and waist circumference. The areas under the curve of the nomogram were 0.793 in the development cohort and 0.774 in the validation cohort. The nomogram performed well for calibration, category-free net reclassification improvement, and integrated discrimination improvement. Decision curve analysis indicated the nomogram performed better than BMI for predicting net outcome. Conclusions: The nomogram was an effective screening tool for fatty liver disease, and for those overweight individuals, may help physicians make appropriate decisions regarding treatment of MAFLD.

Development and validation of a nomogram for predicting metabolic-associated fatty liver disease in the Chinese physical examination population

“…To our knowledge, our nomogram is the rst nomogram for predicting MAFLD risk that is applicable to the Chinese general population and may compensate for some of the shortcomings of previous MAFLD screening tools. For example, the nomogram for predicting the risk of MAFLD in overweight and obese populations reported by Song et al is unavailable to the general population [14] , the sensitivity and speci city of the clinical and laboratory nomogram (CLN) model for predicting NAFLD need improvement, and the CLN model is inapplicable to MAFLD [40] . The MAFLD prediction nomogram based on demography, laboratory factors, anthropometry, and comorbidities can well predict MAFLD but may be inappropriate for the Chinese population because the BMI and WC thresholds for the Asian population differ from the diagnostic criteria for the US population [15] .…”

“…However, these screening tools are inapplicable to the newly de ned condition of MAFLD. A nomogram to predict the risk of MAFLD in overweight and obese people has recently been developed but is suitable only to those with body weight index (BMI) ≥ 24 and male waist circumference (WC) ≥ 90 cm or female WC ≥ 80 cm [14] . Another nonimaging-assisted nomogram established in a large United States (US) population could screen for MAFLD well but has unclear applicability to the Chinese population [15] .…”

Association between TyG-related parameters and non-alcoholic fatty liver disease risk in non-obese individuals: a cross-sectional study based Japanese population

“…Methods for identifying NAFLD primarily include imaging, histology, or serological biomarkers such as serum insulin levels, high-sensitivity C-reactive protein levels, and serum glutamyl transpeptidase levels, along with evidence of overweight/obesity, type 2 diabetes, or metabolic dysregulation 11,12 . However, the applicability and adoption of imaging studies and liver biopsies may be limited in certain healthcare facilities and regions.…”

Development and validation of a nomogram model for predicting the risk of MAFLD in the young population

“…Several simple screening tools for MAFLD have emerged based on demographics, laboratory factors, and anthropometrics 6 , 7 . However, these models may only focus on the overweight population 8 or concentrate solely on the medical population in the United States, thus applicability to Chinese is yet determined 9 . Consequently, no suitable MAFLD screening tool has been developed for the young Chinese population.…”