{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:16:31Z","timestamp":1787026591650,"version":"build-2736575974"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:00:00Z","timestamp":1687996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Nonalcoholic fatty liver disease (NAFLD) is becoming increasingly prevalent worldwide. This study guides the prevention and diagnosis of NAFLD by analyzing its risk factors and the diagnostic value of each index for NAFLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We collected the clinical information of adults individuals who underwent physical examination in the Physical Examination Center of Qingpu Branch of Zhongshan Hospital, Fudan University, from January 2016 to January 2020, including gender, age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). We performed logistic regression analysis and ROC diagnostic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results showed that age, BMI, SBP, ALT, AST, FBG, TBIL, TG, and LDL were risk factors for NAFLD in adults, and HDL was a protective factor (all\n                      <jats:italic>p<\/jats:italic>\n                      -values were less than 0.05). Among them, age, BMI, ALT, TG, and HDL had a predictive value for the occurrence of NAFLD in the adults (AUC\u2009=\u20090.708, 0.836, 0.767, 0.780, and 0.732, respectively). The combination of age, BMI, ALT, TG, and HDL had a diagnostic value for the occurrence of NAFLD (AUC\u2009=\u20090.881).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Healthy people should pay attention to their BMI levels, manage blood pressure, blood glucose, and lipid levels, and pay attention to changes in ALT and AST index levels to prevent NAFLD. Age, BMI, ALT, TG, and HDL indexes are helpful factors in the diagnosis of NAFLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2023.1168499","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T10:06:50Z","timestamp":1688033210000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Analysis of risk factors related to nonalcoholic fatty liver disease: a retrospective study based on 31,718 adult Chinese individuals"],"prefix":"10.3389","volume":"10","author":[{"given":"Ganggang","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yicun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhua","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoliang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes","volume":"64","author":"Younossi","year":"2016","journal-title":"Hepatology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/S2468-1253(19)30039-1","article-title":"Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999-2019: a systematic review and meta-analysis","volume":"4","author":"Li","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1038\/s41591-018-0104-9","article-title":"Mechanisms of NAFLD development and therapeutic strategies","volume":"24","author":"Friedman","year":"2018","journal-title":"Nat Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2737","DOI":"10.2174\/1381612811319150009","article-title":"Redox homeostasis and epigenetics in non-alcoholic fatty liver disease (NAFLD)","volume":"19","author":"Podrini","year":"2013","journal-title":"Curr Pharm Des"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"8131","DOI":"10.1016\/j.vaccine.2018.10.005","article-title":"Vaccine-preventable disease control in the People's Republic of China: 1949-2016","volume":"36","author":"Yu","year":"2018","journal-title":"Vaccine"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"115","DOI":"10.3322\/caac.21338","article-title":"Cancer statistics in China, 2015","volume":"66","author":"Chen","year":"2016","journal-title":"CA Cancer J Clin"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1111\/liv.13709","article-title":"A simple clinical model predicts incident hepatic steatosis in a community-based cohort: the Framingham heart study","volume":"38","author":"Long","year":"2018","journal-title":"Liver 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Gastroenterol","author":"Eguchi","year":"2012"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1097\/MEG.0b013e32832fcdf0","article-title":"Prevalence and factors associated with the presence of nonalcoholic fatty liver disease in an adult population in Spain","volume":"22","author":"Caballer\u00eda","year":"2010","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1159\/000235677","article-title":"Non-alcoholic fatty liver disease in older people","volume":"55","author":"Frith","year":"2009","journal-title":"Gerontology"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1093\/ageing\/afy186","article-title":"The prevalence of non-communicable disease in older people in prison: a systematic review and meta-analysis","volume":"48","author":"Munday","year":"2019","journal-title":"Age 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Clin Nutr"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.tem.2003.09.008","article-title":"Lipid overload and overflow: metabolic trauma and the metabolic syndrome","volume":"14","author":"UNGER","year":"2003","journal-title":"Trends Endocrinol Metab"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"846","DOI":"10.4254\/wjh.v7.i6.846","article-title":"Non-alcoholic fatty liver disease: the diagnosis and management","volume":"7","author":"Abd El-Kader","year":"2015","journal-title":"World J Hepatol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1136\/gutjnl-2015-309265","article-title":"Screening diabetic patients for non-alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: a prospective cohort 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