Anthropometric and blood parameters for the prediction of NAFLD among overweight and obese adults

Tilman Kühn; Tobias Nonnenmacher; Disorn Sookthai; Ruth Schübel; Daniel Antonio Quintana Pacheco; Oyunbileg von Stackelberg; Mirja E Graf; Theron Johnson; Christopher L Schlett; Romy Kirsten; Cornelia M Ulrich; Rudolf Kaaks; Hans-Ulrich Kauczor; Johanna Nattenmüller

doi:10.1186/s12876-018-0840-9

Anthropometric and blood parameters for the prediction of NAFLD among overweight and obese adults

Tilman Kühn, Tobias Nonnenmacher, Disorn Sookthai, Ruth Schübel, Daniel Antonio Quintana Pacheco, Oyunbileg von Stackelberg, Mirja E Graf, Theron Johnson, Christopher L Schlett, Romy Kirsten, Cornelia M Ulrich, Rudolf Kaaks, Hans-Ulrich Kauczor, Johanna Nattenmüller

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Abstract

BACKROUND: Non-alcoholic fatty liver disease (NAFLD) comprises non-progressive steatosis and non-alcoholic steatohepatitis (NASH), the latter of which may cause cirrhosis and hepatocellular carcinoma (HCC). As NAFLD detection is imperative for the prevention of its complications, we evaluated whether a combination of blood-based biomarkers and anthropometric parameters can be used to predict NAFLD among overweight and obese adults.

METHODS: 143 overweight or obese non-smokers free of diabetes (50% women, age: 35-65 years) were recruited. Anthropometric indices and routine biomarkers of metabolism and liver function were measured to predict magnetic resonance (MR) - derived NAFLD by multivariable logistic regression models. In addition, we evaluated to which degree the use of more novel biomarkers (adiponectin, leptin, resistin, C-reactive protein, TNF-α, IL-6, IL-8 and interferon-γ) could improve prediction models.

RESULTS: NAFLD was best predicted by a combination of age, sex, waist circumference, ALT, HbA1c, and HOMA-IR at an area under the receiver operating characteristic curve (AUROC) of 0.87 (95% CI: 0.81, 0.93) before and 0.85 (95% CI: 0.78, 0.91) after internal bootstrap validation. The use of additional biomarkers of inflammation and metabolism did not improve NAFLD prediction. Previously published indices predicted NAFLD at AUROCs between 0.71 and 0.82.

CONCLUSIONS: The AUROC of > 0.8 obtained by our regression model suggests the feasibility of a non-invasive detection of NAFLD by anthropometry and circulating biomarkers, even though further increments in the capacity of prediction models may be needed before NAFLD indices can be applied in routine clinical practice.

Original language	English
Pages (from-to)	113
Journal	BMC Gastroenterology
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s12876-018-0840-9
Publication status	Published - 13 Jul 2018
Externally published	Yes

Keywords

Adult
Aged
Alanine Transaminase/blood
Anthropometry
Biomarkers/blood
Female
Glycated Hemoglobin A/analysis
Humans
Insulin Resistance
Male
Middle Aged
Models, Statistical
Non-alcoholic Fatty Liver Disease/blood
Obesity/complications
Overweight/complications

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12876-018-0840-9Licence: CC BY

Anthropometric and blood parameters for the prediction of NAFLD among overweight and obese adults
Copyright 2020 the authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 1.13 MBLicence: CC BY

Cite this

Kühn, T., Nonnenmacher, T., Sookthai, D., Schübel, R., Quintana Pacheco, D. A., von Stackelberg, O., Graf, M. E., Johnson, T., Schlett, C. L., Kirsten, R., Ulrich, C. M., Kaaks, R., Kauczor, H.-U., & Nattenmüller, J. (2018). Anthropometric and blood parameters for the prediction of NAFLD among overweight and obese adults. BMC Gastroenterology, 18(1), 113. https://doi.org/10.1186/s12876-018-0840-9

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title = "Anthropometric and blood parameters for the prediction of NAFLD among overweight and obese adults",

abstract = "BACKROUND: Non-alcoholic fatty liver disease (NAFLD) comprises non-progressive steatosis and non-alcoholic steatohepatitis (NASH), the latter of which may cause cirrhosis and hepatocellular carcinoma (HCC). As NAFLD detection is imperative for the prevention of its complications, we evaluated whether a combination of blood-based biomarkers and anthropometric parameters can be used to predict NAFLD among overweight and obese adults.METHODS: 143 overweight or obese non-smokers free of diabetes (50% women, age: 35-65 years) were recruited. Anthropometric indices and routine biomarkers of metabolism and liver function were measured to predict magnetic resonance (MR) - derived NAFLD by multivariable logistic regression models. In addition, we evaluated to which degree the use of more novel biomarkers (adiponectin, leptin, resistin, C-reactive protein, TNF-α, IL-6, IL-8 and interferon-γ) could improve prediction models.RESULTS: NAFLD was best predicted by a combination of age, sex, waist circumference, ALT, HbA1c, and HOMA-IR at an area under the receiver operating characteristic curve (AUROC) of 0.87 (95% CI: 0.81, 0.93) before and 0.85 (95% CI: 0.78, 0.91) after internal bootstrap validation. The use of additional biomarkers of inflammation and metabolism did not improve NAFLD prediction. Previously published indices predicted NAFLD at AUROCs between 0.71 and 0.82.CONCLUSIONS: The AUROC of > 0.8 obtained by our regression model suggests the feasibility of a non-invasive detection of NAFLD by anthropometry and circulating biomarkers, even though further increments in the capacity of prediction models may be needed before NAFLD indices can be applied in routine clinical practice.",

keywords = "Adult, Aged, Alanine Transaminase/blood, Anthropometry, Biomarkers/blood, Female, Glycated Hemoglobin A/analysis, Humans, Insulin Resistance, Male, Middle Aged, Models, Statistical, Non-alcoholic Fatty Liver Disease/blood, Obesity/complications, Overweight/complications",

author = "Tilman K{\"u}hn and Tobias Nonnenmacher and Disorn Sookthai and Ruth Sch{\"u}bel and {Quintana Pacheco}, {Daniel Antonio} and {von Stackelberg}, Oyunbileg and Graf, {Mirja E} and Theron Johnson and Schlett, {Christopher L} and Romy Kirsten and Ulrich, {Cornelia M} and Rudolf Kaaks and Hans-Ulrich Kauczor and Johanna Nattenm{\"u}ller",

year = "2018",

month = jul,

day = "13",

doi = "10.1186/s12876-018-0840-9",

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volume = "18",

pages = "113",

journal = "BMC Gastroenterology",

issn = "1471-230x",

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Kühn, T, Nonnenmacher, T, Sookthai, D, Schübel, R, Quintana Pacheco, DA, von Stackelberg, O, Graf, ME, Johnson, T, Schlett, CL, Kirsten, R, Ulrich, CM, Kaaks, R, Kauczor, H-U & Nattenmüller, J 2018, 'Anthropometric and blood parameters for the prediction of NAFLD among overweight and obese adults', BMC Gastroenterology, vol. 18, no. 1, pp. 113. https://doi.org/10.1186/s12876-018-0840-9

TY - JOUR

T1 - Anthropometric and blood parameters for the prediction of NAFLD among overweight and obese adults

AU - Kühn, Tilman

AU - Nonnenmacher, Tobias

AU - Sookthai, Disorn

AU - Schübel, Ruth

AU - Quintana Pacheco, Daniel Antonio

AU - von Stackelberg, Oyunbileg

AU - Graf, Mirja E

AU - Johnson, Theron

AU - Schlett, Christopher L

AU - Kirsten, Romy

AU - Ulrich, Cornelia M

AU - Kaaks, Rudolf

AU - Kauczor, Hans-Ulrich

AU - Nattenmüller, Johanna

PY - 2018/7/13

Y1 - 2018/7/13

N2 - BACKROUND: Non-alcoholic fatty liver disease (NAFLD) comprises non-progressive steatosis and non-alcoholic steatohepatitis (NASH), the latter of which may cause cirrhosis and hepatocellular carcinoma (HCC). As NAFLD detection is imperative for the prevention of its complications, we evaluated whether a combination of blood-based biomarkers and anthropometric parameters can be used to predict NAFLD among overweight and obese adults.METHODS: 143 overweight or obese non-smokers free of diabetes (50% women, age: 35-65 years) were recruited. Anthropometric indices and routine biomarkers of metabolism and liver function were measured to predict magnetic resonance (MR) - derived NAFLD by multivariable logistic regression models. In addition, we evaluated to which degree the use of more novel biomarkers (adiponectin, leptin, resistin, C-reactive protein, TNF-α, IL-6, IL-8 and interferon-γ) could improve prediction models.RESULTS: NAFLD was best predicted by a combination of age, sex, waist circumference, ALT, HbA1c, and HOMA-IR at an area under the receiver operating characteristic curve (AUROC) of 0.87 (95% CI: 0.81, 0.93) before and 0.85 (95% CI: 0.78, 0.91) after internal bootstrap validation. The use of additional biomarkers of inflammation and metabolism did not improve NAFLD prediction. Previously published indices predicted NAFLD at AUROCs between 0.71 and 0.82.CONCLUSIONS: The AUROC of > 0.8 obtained by our regression model suggests the feasibility of a non-invasive detection of NAFLD by anthropometry and circulating biomarkers, even though further increments in the capacity of prediction models may be needed before NAFLD indices can be applied in routine clinical practice.

AB - BACKROUND: Non-alcoholic fatty liver disease (NAFLD) comprises non-progressive steatosis and non-alcoholic steatohepatitis (NASH), the latter of which may cause cirrhosis and hepatocellular carcinoma (HCC). As NAFLD detection is imperative for the prevention of its complications, we evaluated whether a combination of blood-based biomarkers and anthropometric parameters can be used to predict NAFLD among overweight and obese adults.METHODS: 143 overweight or obese non-smokers free of diabetes (50% women, age: 35-65 years) were recruited. Anthropometric indices and routine biomarkers of metabolism and liver function were measured to predict magnetic resonance (MR) - derived NAFLD by multivariable logistic regression models. In addition, we evaluated to which degree the use of more novel biomarkers (adiponectin, leptin, resistin, C-reactive protein, TNF-α, IL-6, IL-8 and interferon-γ) could improve prediction models.RESULTS: NAFLD was best predicted by a combination of age, sex, waist circumference, ALT, HbA1c, and HOMA-IR at an area under the receiver operating characteristic curve (AUROC) of 0.87 (95% CI: 0.81, 0.93) before and 0.85 (95% CI: 0.78, 0.91) after internal bootstrap validation. The use of additional biomarkers of inflammation and metabolism did not improve NAFLD prediction. Previously published indices predicted NAFLD at AUROCs between 0.71 and 0.82.CONCLUSIONS: The AUROC of > 0.8 obtained by our regression model suggests the feasibility of a non-invasive detection of NAFLD by anthropometry and circulating biomarkers, even though further increments in the capacity of prediction models may be needed before NAFLD indices can be applied in routine clinical practice.

KW - Adult

KW - Aged

KW - Alanine Transaminase/blood

KW - Anthropometry

KW - Biomarkers/blood

KW - Female

KW - Glycated Hemoglobin A/analysis

KW - Humans

KW - Insulin Resistance

KW - Male

KW - Middle Aged

KW - Models, Statistical

KW - Non-alcoholic Fatty Liver Disease/blood

KW - Obesity/complications

KW - Overweight/complications

U2 - 10.1186/s12876-018-0840-9

DO - 10.1186/s12876-018-0840-9

M3 - Article

C2 - 30005625

SN - 1471-230x

VL - 18

SP - 113

JO - BMC Gastroenterology

JF - BMC Gastroenterology

IS - 1

ER -

Anthropometric and blood parameters for the prediction of NAFLD among overweight and obese adults

Abstract

Keywords

UN SDGs

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