Chunming et al developed a simple score for the diagnosis of steatohepatitis in a patient with nonalcoholic fatty liver disease. The authors are from The Affiliated Zhenjiang Third Hospital, Jjiangu University in Zhenjiang, China.
Patient selection: nonalcoholic steatohepatitis
Parameters:
(1) serum ALT (reference range 0 to 40 IU/L)
(2) serum GGT (reference range 0 to 42 IU/L)
(3) serum C-reactive protein (CRP; reference range 0 to 7 mg/dL)
(4) apolipoprotein B to apolipoprotein A1 ratio (reference range apoB 0.8 to 1.1 g/L; reference range apoA1 1.2-1.6 g/L)
Parameter
Findings
Points
serum ALT
< 75 IU/L
0
>= 75 IU/L
2
serum GGT
< 55 U/L
0
>= 55 IU/L
2
serum C-reactive protein
< 5.6 mg/L
0
>= 5.6 mg/L
1
apoB to apoA1 ratio
< 0.8
0
>= 0.8
1
where:
• Units for CRP are mg/dL in biochemical analyses and mg/L in discussion. The units in the biochemical analysis probably should be mg/L.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A score >= 4 is predictive of steatohepatitis (cutoff given as > 3.8 but only digits used).
Performance:
• The authors claim an area under the ROC curve of 0.90.
• The sensitivity was 0.88 and specificity 0.90 using >= 4 as cutoff.
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