Performance Analysis and Assessment of Type 2 Diabetes Screening Scores in Patients with Non-Alcoholic Fatty Liver Disease

Abstract

Type 2 diabetes (T2D) and non-alcoholic fatty liver disease (NAFLD) are worldwide chronic diseases that have strong relationships with one another and commonly exist together. Type 2 diabetes is considered one of the risk factors for NAFLD, so its occurrence in people with NAFLD is highly likely. As the high and increasing number of T2D and NAFLD, which potentially followed by existing together number, an analysis and assessment of T2D screening scores in people with NAFLD is necessary to be done. To prevent this potential case, an effective early prediction model is also required to be developed, which could help the patients avoid the dangers of both existing diseases. Therefore, in this study, analysis and assessment of T2D screening scores in people with NAFLD and the early prediction model utilizing a forward logistic regression-based feature selection method and multi-layer perceptrons are proposed. Our analysis and assessment results showed that the prevalence of T2D among patients with NAFLD was 8.13% (for prediabetes) and 37.19% (for diabetes) in two population-based NAFLD datasets. The variables related to clinical tests, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and systolic blood pressure (SBP), were found to be statistically significant predictors (p-values < 0.001) that indicate a strong association with T2D among patients with NAFLD in both the prediabetes and diabetes NAFLD datasets. Finally, our proposed model showed the best performance in terms of all performance evaluation metrics compared to existing various machine learning models and also the models using variables recommended by WHO/CDC/ADA, with achieved accuracy as much as 92.11% and 83.05% and its improvement scores after feature selection of 1.35% and 5.35%, for the first and second dataset, respectively.