The utility of an artificial intelligence model based on decision tree and evolution algorithm to evaluate steatotic...

Many ways of classifying steatotic liver disease (SLD) with metabolic conditions have been proposed. Thus, SLD-related variables were verified using a decision tree. We tested if the suggested components of the actual classification (metabolic dysfunction-associated steatotic liver disease, MASLD) are also present in young and middle-aged adults. In a cross-sectional study involving 6,839 adults (median age: 46 years, 69.5% men) in a primary care setting, a decision tree was created to determine potential clinical and laboratory variables related to SLD. The odds ratio (OR) with a respective 95% confidence interval (95%CI) was calculated for both sexes. SLD frequency was 26.6% (23% in men). More variables and with higher ORs for the association with SLD were identified in women: category 1 (body mass index (BMI) ≥29 kg/m2, age <51 years, high-sensitivity C-reactive protein (hs-CRP) ≥0.195 mg/dL): OR=10.9, 95%CI: 4.40-26.6; category 2 (BMI <9 kg/m2, metabolic syndrome (MS), age ≥50 years, neck circumference (NC) ≥36 cm): OR=8.1, 95%CI: 2.2-29.9; and category 3 (BMI ≥29 kg/m2, age <51 y-old, dyslipidemia, high-density lipoprotein cholesterol (HDL-c) <42 mg/dL): OR=4.7, 95%CI: 2.20-10.7. For men: category 1 (waist circumference (WC) ≥101 cm, alanine aminotransferase (ALT) <28 mg/dL, glycated hemoglobin (HbA1c) ≥5.7%): OR=4.7, 95%CI: 2.8-7.9; and category 2 (WC ≥101 cm, ALT ≥28 mg/dL): OR=3.2, 95%CI: 2.5-4.0). The decision tree identified more variables related to SLD, particularly in women, such as age of more than 50 years, elevated hs-CRP, and NC≥36 cm than variables related to MASLD.