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The objective was to develop a simple clinical score to screen for NAFLD risk in obese adolescents with PCOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This is a secondary analysis of 3 cross\u2010sectional studies on metabolic characterization of obese adolescents with PCOS. 108 overweight and obese adolescents with PCOS (BMI\u00a0&gt;\u00a090th percentile, age 12\u201019\u00a0years) were enrolled from 2012 to 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Magnetic resonance imaging was used to quantify hepatic fat fraction (HFF). A development cohort of 87 girls were divided by presence of NAFLD (HFF\u00a0&gt;\u00a05.5%). A logistic regression model with the outcome of NAFLD and candidate predictor variables was fit. A simplified model (PCOS\u2010HS index) was created using backwards stepdown elimination. Validation was performed using 200 bootstrapped sample and in a second cohort of 21 PCOS participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>52% of the development cohort had NAFLD. The PCOS\u2010HS index that included BMI percentile, waist circumference, ALT and SHBG had an AUCROC of 0.81, sensitivity 82%, specificity 69%, negative predictive value (NPV) 78% and positive predictive value 74%, using a threshold of 0.44 to predict HS. A threshold of 0.15 ruled out NAFLD with a NPV 90%. In the validation cohort, the model showed an accuracy of 81%, sensitivity of 91% and specificity of 70%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We developed a clinical index to identify NAFLD in girls with PCOS who would need further evaluation and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14062","type":"journal-article","created":{"date-parts":[[2019,7,13]],"date-time":"2019-07-13T19:59:49Z","timestamp":1563047989000},"page":"544-552","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Clinical prediction score of nonalcoholic fatty liver disease in adolescent girls with polycystic ovary syndrome (PCOS\u2010HS index)"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0652-8434","authenticated-orcid":false,"given":"Anne\u2010Marie","family":"Carreau","sequence":"first","affiliation":[{"name":"Division of Pediatric Endocrinology, 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Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0477-3356","authenticated-orcid":false,"given":"Kristen J.","family":"Nadeau","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics University of Colorado Anschutz Medical Campus Aurora Colorado"},{"name":"Center for Women's Health Research University of Colorado Anschutz Medical Campus Aurora Colorado"},{"name":"Barbara Davis Center for Childhood Diabetes University of Colorado Anschutz Medical Campus Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1593-1695","authenticated-orcid":false,"given":"Melanie","family":"Cree\u2010Green","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics University of Colorado Anschutz Medical Campus Aurora Colorado"},{"name":"Center for Women's Health Research University of 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