Phenotypes of non-alcoholic fatty liver disease (NAFLD) and all-cause mortality: unsupervised machine learning analysis of NHANES III

Carrillo-Larco, Rodrigo M, Guzman Vilca, Wilmer Cristobal, Castillo Cara, Manuel, Alvizuri Gómez, Claudia, Alqahtani, Saleh y Garcia Larsen, Vanessa . (2022) Phenotypes of non-alcoholic fatty liver disease (NAFLD) and all-cause mortality: unsupervised machine learning analysis of NHANES III. BMJ Open

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Título Phenotypes of non-alcoholic fatty liver disease (NAFLD) and all-cause mortality: unsupervised machine learning analysis of NHANES III
Autor(es) Carrillo-Larco, Rodrigo M
Guzman Vilca, Wilmer Cristobal
Castillo Cara, Manuel
Alvizuri Gómez, Claudia
Alqahtani, Saleh
Garcia Larsen, Vanessa
Materia(s) Informática
Resumen Objectives Non- alcoholic fatty liver disease (NAFLD) is a non-communicable disease with a rising prevalence worldwide and with large burden for patients and health systems. To date, the presence of unique phenotypes in patients with NAFLD has not been studied, and their identification could inform precision medicine and public health with pragmatic implications in personalised management and care for patients with NAFLD. Design Cross-sectional and prospective (up to 31 December 2019) analysis of National Health and Nutrition Examination Survey III (1988–1994). Primary and secondary outcomes measures NAFLD diagnosis was based on liver ultrasound. The following predictors informed an unsupervised machine learning algorithm (k-means): body mass index, waist circumference, systolic blood pressure (SBP), plasma glucose, total cholesterol, triglycerides, liver enzymes alanine aminotransferase, aspartate aminotransferase and gamma glutamyl transferase. We summarised (means) and compared the predictors across clusters. We used Cox proportional hazard models to quantify the all-cause mortality risk associated with each cluster. Results 1652 patients with NAFLD (mean age 47.2 years and 51.5% women) were grouped into 3 clusters: anthro-SBP- glucose (6.36%; highest levels of anthropometrics, SBP and glucose), lipid-liver (10.35%; highest levels of lipid and liver enzymes) and average (83.29%; predictors at average levels). Compared with the average phenotype, the anthro-SBP- glucose phenotype had higher all-cause mortality risk (aHR=2.88; 95% CI: 2.26 to 3.67); the lipid-liver phenotype was not associated with higher all-cause mortality risk (aHR=1.11; 95% CI: 0.86 to 1.42). Conclusions There is heterogeneity in patients with NAFLD, whom can be divided into three phenotypes with different mortality risk. These phenotypes could guide specific interventions and management plans, thus advancing precision medicine and public health for patients with NAFLD.
Editor(es) BMJ Publishing Group
Fecha 2022-11-23
Formato application/pdf
Identificador bibliuned:557-Jmcastillo-0005
http://e-spacio.uned.es/fez/view/bibliuned:557-Jmcastillo-0005
DOI - identifier https://doi.org/10.1136/bmjopen-2022-067203
ISSN - identifier 2044-6055
Nombre de la revista BMJ Open
Número de Volumen 12
Número de Issue 11
Publicado en la Revista BMJ Open
Idioma eng
Versión de la publicación publishedVersion
Tipo de recurso Article
Derechos de acceso y licencia http://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
Tipo de acceso Acceso abierto
Notas adicionales La versión registrada de este artículo, publicado por primera vez en BMJ Open, está disponible en línea en el sitio web del editor: BMJ Publishing Group https://doi.org/10.1136/bmjopen-2022-067203
Notas adicionales The registered version of this article, first published in BMJ Open, is available online at the publisher's website: BMJ Publishing Group https://doi.org/10.1136/bmjopen-2022-067203

 
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Creado: Wed, 28 Feb 2024, 18:36:36 CET