Analysis Of The Value Of FibroTouch Alone And Combined With Multiple Indexes In The Diagnosis Of NAFLD

Objective:NAFLD is a chronic liver parenchyma injury disease related to metabolic risk factors such as obesity,insulin resistance,dyslipidemia and so on.So early diagnosis and long-term monitoring are particularly important.Non-invasive diagnosis of NAFLD is a research hotspot at home and abroad.We analyzed the clinical data of NAFLD and the control group,discussed the clinical characteristics and factors of NAFLD patients,used Fibro Touch(FT)to evaluate the sensitivity and specificity of FT in the diagnosis of hepatic steatosis.We tried to apply CAP combined with other factors to explore the combination index of diagnosis of NAFLD,so as to improve the understanding of the disease and provide theoretical basis for diagnosis of NAFLD.Exploring a method which could help monitoring of hepatic steatosis for a long-term.Methods:We screened the patients with NAFLD who were admitted to the Department of Hepatology of Tai Zhou people’s Hospital from January 2017 to January 2020 and those who had normal physical examination results in the physical examination center.They were divided into NAFLD group and control group according to the diagnostic criteria of NAFLD guidelines.The sex,age,CAP of liver,BMI,L/S,liver function,renal function,blood routine,blood glucose,blood lipid,hypertension,diabetes,smoking history,regular schedule and other clinical data of the two groups were analyzed.SPSS26.0 was used for statistical analysis.T-test,linear correlation analysis,binary logistic regression,multivariate analysis and area under ROC working curve were used to analyze the clinical characteristics of NAFLD patients,to evaluate the sensitivity and specificity of FT in the diagnosis of NAFLD,and to explore the value of FT combined with multiple factors in the diagnosis of NAFLD according to the collected data,so as to provide a reference method for long-term clinical monitoring of hepatic steatosis.Results:A total of 99 subjects were enrolled,including 68 in the NAFLD group and 31 in the control group.The average age of the NAFLD group was 43.66 ±12.96 years old,and that of the control group was 42.23 ±11.38 years old.There was no significant difference in age between the two groups.There were differences in gender,hypertension,diabetes and routine between the NAFLD group and the control group.BMI,CAP,LSM,CHOL,LDL,TG,ALT,AST,UA,WBC and C3 in NAFLD group were higher than those in control group,while HDL and L/S in NAFLD group were significantly lower.Univariate analysis showed that the increase of CAP,LSM,BMI,ALT,AST,CHOL,LDL,UA,WBC index and the decrease of L/S and HDL index had influence on NAFLD,which was statistically significant.Under the imaging definition,the NAFLD standard of FT was consistent in the detection of hepatic steatosis,with a Kappa value of 0.779(P < 0.001);The detection rates of hepatic steatosis detected by FT and CT were 73.7% and 49.5%,respectively.The AUROC of CAP for diagnosing NAFLD is 0.838(95%CI:0.752-0.924),the sensitivity and specificity are 77.9% and80.6%,and the best cut-off number is 262.365 d B/m.Multivariate analysis showed that the area under the working curve of CAP combined with L/S,HDL,LDL and CHOL was 0.940(95%CI:0.895-0.985),the sensitivity was 86.8%,and the specificity was90.3%.Conclusion:The incidence of NAFLD is different between males and females,and the incidence in males(46.4%)is higher than that in females(22.2%).The increase of CAP,LSM,BMI,ALT,AST,CHOL,LDL,UA,WBC and the decrease of HDL,L/S had influence on NAFLD.Multivariate analysis showed that the increase of CAP and the decrease of HDL and L/S were the risk factors of NAFLD.FT is of good for detecting hepatic steatosis.The AUROC of CAP for diagnosing NAFLD is 0.838(95%CI:0.752-0.924),the sensitivity and specificity are 77.9% and 80.6%,and the best cut-off number is 262.365 d B/m.The area under the AUROC curve of CAP combined with multiple factors(L/S,HDL,LDL,CHOL)for the diagnosis of NAFLD was 0.940,(95%CI:0.895-0.985),and the sensitivity and specificity were 86.8% and 90.3%,respectively,which were better than those of single factor diagnosis of NAFLD.In conclusion,FT has a high accuracy in the diagnosis of NAFLD,and can be used to evaluate the degree of hepatic steatosis in patients.CAP combined with LBG S,HDL,LDL and CHOL can diagnose NAFLD more accurately,which can be used as a method for long-term monitoring and evaluation of hepatic steatosis in patients with NAFLD.