{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:03:37Z","timestamp":1781327017945,"version":"3.54.1"},"reference-count":61,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100025478","name":"Taoyuan Armed Forces General Hospital","doi-asserted-by":"crossref","award":["TYAFGH_E_113057"],"award-info":[{"award-number":["TYAFGH_E_113057"]}],"id":[{"id":"10.13039\/501100025478","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004319","name":"Shin Kong Wu Ho-Su Memorial Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004319","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Non-alcoholic fatty liver disease (NAFLD) represents the most widespread chronic liver disorder globally, impacting roughly 30% of the general population. Numerous factors have been linked to NAFLD, including obesity, type 2 diabetes, diet, physical inactivity, age, sex, genetic factors, and metabolic syndrome. Previous research predominantly treated NAFLD as a categorical outcome, providing less granular data compared to the continuous fatty liver index (FLI). This investigation enrolled healthy young Taiwanese men and applied multivariate adaptive regression spline (MARS) modeling to develop a predictive equation. Our aims were twofold: 1. To assess the predictive accuracy of traditional multiple linear regression (MLR) versus MARS. 2. To construct a MARS-derived equation for estimating FLI in this demographic. Methods: Data originated from the Taiwan MJ Cohort, comprising 5496 men aged 20\u201350 years not using medications for metabolic syndrome. MARS was used to formulate the FLI estimation equation. Model performance was compared using symmetric mean absolute percentage error (SMAPE), relative absolute error (RAE), root relative squared error (RRSE), and root mean squared error (RMSE). Results: Evaluation indicated that MARS yielded lower estimation errors than MLR, demonstrating its superior performance. The derived equation is: FLI = 65.224 \u2212 0.436 \u00d7 B1 \u2212 0.490 \u00d7 B2 + 0.252 \u00d7 B3 \u2212 2.962 \u00d7 B4 + 2.231 \u00d7 B5 \u2212 0.292 \u00d7 B6 + 0.189 \u00d7 B7 \u2212 0.361 \u00d7 B8 \u2212 0.699 \u00d7 B9 + 0.160 \u00d7 B10 \u2212 2.715 \u00d7 B11 + 0.799 \u00d7 B12 \u2212 0.153 \u00d7 B13 + 0.084 \u00d7 B14 \u2212 35.274 \u00d7 B15 \u2212 4.424 \u00d7 B16. Conclusions: Using MLR as a benchmark, our analysis revealed that MARS delivered better predictive performance. The presented equation explains 62.7% of the variance in FLI (r2 = 0.627). Based on standardized variable importance scores (nsubsets metric), CRP emerged as the most influential predictor, followed by WBC, UA, HDL-C, AST, age, ALT, FPG, SBP, and LDL in this cohort of healthy young Taiwanese men.<\/jats:p>","DOI":"10.3390\/diagnostics16050795","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T13:27:18Z","timestamp":1773062838000},"page":"795","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Application of Multivariate Adaptive Regression Splines to Estimate Fatty Liver Index in Healthy Young Taiwanese Men"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0991-4443","authenticated-orcid":false,"given":"Po-Chung","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Family Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325208, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8271-2885","authenticated-orcid":false,"given":"Chung-Chi","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325208, Taiwan"},{"name":"Cardiovascular Division, Tri-Service General Hospital, National Defense Medical University, Taipei 114202, Taiwan"},{"name":"School of Medicine, National Tsing Hua University, Hsinchu 300044, Taiwan"},{"name":"Institute of Bioinformatics and Structural Biology, National Tsing Hua University, Hsinchu 300044, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dee","family":"Pei","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, College of Medicine, Fu Jen Catholic University, New Taipei 242062, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7629-7854","authenticated-orcid":false,"given":"Ta-Wei","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical University, Taipei 114202, Taiwan"},{"name":"MJ Health Research Foundation, Taipei 114066, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyh-Gang","family":"Leu","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111045, Taiwan"},{"name":"School of Medicine, Fu-Jen Catholic University, New Taipei 242062, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/S2468-1253(22)00165-0","article-title":"The prevalence and incidence of NAFLD worldwide: A systematic review and meta-analysis","volume":"7","author":"Riazi","year":"2022","journal-title":"Lancet Gastroenterol. 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