Development and validation of a model to predict incident chronic liver disease in the general population: The CLivD score

作者：Fredrik O. Åberg, Panu K. Luukkonen, Anna But, Veikko V Salomaa, Annie R Britton, Kasper Meidahl Petersen, Stig E. Bojesen, Mie Balling, Børge Grønne Nordestgaard, Pauli J. Puukka, Satu Männistö, Annamari Lundqvist, Markus Perola, Antti Jula, Martti A. Färkkilä · 发表于：Journal of Hepatology · 年份：2022 · DOI：10.1016/j.jhep.2022.02.021 · 被引用次数：74 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Hepatitis C virus research

Background & Aims Current screening strategies for chronic liver disease focus on detection of subclinical advanced liver fibrosis but cannot identify those at high future risk of severe liver disease. Our aim was to develop and validate a risk prediction model for incident chronic liver disease in the general population based on widely available factors. Methods Multivariable Cox regression analyses were used to develop prediction models for liver-related outcomes with and without laboratory measures (Model lab and Model non-lab ) in 25,760 individuals aged 40–70 years. Their data were sourced from the Finnish population-based health examination surveys FINRISK 1992-2012 and Health 2000 (derivation cohort). The models were externally validated in the Whitehall II (n = 5,058) and Copenhagen City Heart Study (CCHS) (n = 3,049) cohorts. Results The absolute rate of incident liver outcomes per 100,000 person-years ranged from 53 to 144. The final prediction model included age, sex, alcohol use (drinks/week), waist–hip ratio, diabetes, and smoking, and Model lab also included gamma-glutamyltransferase values. Internally validated Wolbers' C-statistics were 0.77 for Model lab and 0.75 for Model non-lab , while apparent 15-year AUCs were 0.84 (95% CI 0.75-0.93) and 0.82 (95% CI 0.74-0.91). The models identified a small proportion (<2%) of the population with >10% absolute 15-year risk for liver events. Of all liver events, only 10% occurred in participants in the lowest risk catego...