Machine learning-based identification of biochemical markers to predict hepatic steatosis in patients at high metabolic risk

Table 1 The 81 correlated factors associated with metabolic-associated fatty liver disease

Spearman rank correlation
Indicators	r value	n	P value	Correlation coefficient	Correlation ranking
ALT	0.506	979	0.000	0.506	1
AST/ALT	-0.495	831	0.000	0.495	2
γ-GT	0.366	828	0.000	0.366	3
TG	0.358	917	0.000	0.358	4
BMI	0.353	867	0.000	0.353	5
AST	0.346	832	0.000	0.346	6
WC	0.331	774	0.000	0.331	7
Weight	0.303	778	0.000	0.303	8
UA/Cr ratio	0.288	972	0.000	0.288	9
Cr/weight ratio	-0.255	770	0.000	0.255	10
Waist-to-hip ratio	0.254	773	0.000	0.254	11
HDL-C	-0.25	907	0.000	0.25	12
HbA1c	0.246	495	0.000	0.246	13
Average heart rate	0.233	860	0.000	0.233	14
Hip circumference	0.225	774	0.000	0.225	15
UA	0.22	972	0.000	0.22	16
Kidney meridian	0.208	860	0.000	0.208	17
FPSA	-0.194	444	0.000	0.194	18
WBC	0.191	978	0.000	0.191	19
CRP	0.187	261	0.002	0.187	20
Absolute value of lymphocytes	0.186	981	0.000	0.186	21
Exercise type	-0.185	711	0.000	0.185	22
Intraocular pressure of the left eye	0.185	446	0.000	0.185	23
Glucose	0.183	911	0.000	0.183	24
Liver meridian	0.178	860	0.000	0.178	25
Hemoglobin	0.177	981	0.000	0.177	26
Gallbladder meridian	-0.177	860	0.000	0.177	27
RBC	0.173	980	0.000	0.173	28
Duration of each exercise session	-0.172	700	0.000	0.172	29
Number of exercise sessions per week	-0.171	701	0.000	0.171	30
Pericardium meridian	-0.17	860	0.000	0.17	31
Redness at the sides and tips	-0.169	924	0.000	0.169	32
Spleen meridian	-0.157	860	0.000	0.157	33
PA	0.152	683	0.000	0.152	34
Absolute value of eosinophils	0.15	981	0.000	0.15	35
T3 triiodothyronine	0.15	764	0.000	0.15	36
HCT	0.148	979	0.000	0.148	37
GLO	0.143	769	0.000	0.143	38
Neu/ALB ratio	0.142	929	0.000	0.142	39
Coating at left side of tongue lab-a1	-0.139	924	0.000	0.139	40
Absolute value of neutrophils	0.135	981	0.000	0.135	41
Left side of tongue lab-a	-0.131	924	0.000	0.131	42
Absolute value of monocytes	0.13	981	0.000	0.13	43
Coating at root of tongue lab-a	-0.129	924	0.000	0.129	44
Coating at full tongue lab-a	-0.129	924	0.000	0.129	45
Systolic blood pressure	0.126	786	0.000	0.126	46
Root of tongue lab-a	-0.124	924	0.000	0.124	47
PCT	0.123	889	0.000	0.123	48
Middle of tongue lab-L	0.123	924	0.000	0.123	49
Left side of tongue lab-L	0.122	924	0.000	0.122	50
Coating at left side of tongue lab-L	0.12	924	0.000	0.12	51
PLT	0.119	981	0.000	0.119	52
Coating at tip of tongue lab-a	-0.119	924	0.000	0.119	53
Coating at full tongue lab-l	0.119	924	0.000	0.119	54
TP	0.118	929	0.000	0.118	55
Coating at right side of tongue lab-a	-0.116	924	0.000	0.116	56
Right side of tongue lab-a	-0.115	924	0.000	0.115	57
Tip of tongue lab-l	0.115	924	0.000	0.115	58
Coating at tip of tongue lab-l	-0.114	924	0.000	0.114	59
Coating at middle of tongue lab-l	0.114	924	0.001	0.114	60
Coating at middle of tongue lab-l	0.113	924	0.001	0.113	61
Right side of tongue lab-l	0.109	924	0.001	0.109	62
RDW-SD	-0.107	889	0.001	0.107	63
Coating at middle of tongue lab-a	-0.106	924	0.001	0.106	64
Diastolic blood pressure	0.104	786	0.003	0.104	65
Middle of tongue lab-a	-0.103	924	0.002	0.103	66
Left side of tongue lab-b	-0.103	924	0.002	0.103	67
Coating at right side of tongue lab-l	0.103	924	0.002	0.103	68
Coating at tip of tongue lab-b	-0.102	924	0.002	0.102	69
Absolute value of basophils	0.101	981	0.002	0.101	70
MCHC	0.1	889	0.003	0.1	71
Tip of tongue lab-b	-0.1	924	0.002	0.1	72
Root of tongue lab-b	-0.099	924	0.003	0.099	73
Coating at root of tongue lab-l	0.099	924	0.003	0.099	74
ALP	0.098	798	0.006	0.098	75
Root of tongue lab-l	0.097	924	0.003	0.097	76
Right side of tongue lab-b	-0.096	924	0.004	0.096	77
Coating at left side of tongue lab-b	-0.096	924	0.004	0.096	78
Coating at full tongue lab-b	-0.096	924	0.003	0.096	79
Coating at right side of tongue lab-b	-0.094	924	0.004	0.094	80
MCV	-0.09	889	0.007	0.09	81

¹l value: Indicates the lightness of an image, the higher the value, the greater the brightness; a value: Distinguishes the redness of the tongue body and the thickness of the tongue coating; b value: Distinguishes the white/yellow of the tongue coating, positively correlated, a white coating has a lower overall b value, while a yellow coating has a higher overall b value.

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; γ-GT: Gamma-glutamyl transferase; TG: Triglyceride; BMI: Body mass index; WC: Waist circumference; UA: Uric acid; Cr: Creatinine; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; HbA1c: Glycated hemoglobin; FPSA: Free prostate-specific antigen; WBC: White blood cell count; CRP: C-reactive protein; RBC: Red blood cell count; PA: Peak expiratory flow; HCT: Hematocrit; GLO: Globulin; Neu: Neutrophil; ALB: Albumin; PCT: Procalcitonin; PLT: Platelets; TP: Total protein; RDW: Red cell distribution width; MCHC: Mean corpuscular hemoglobin concentration; ALP: Alkaline phosphatase; MCV: Mean corpuscular volume.

Table 2 High linear correlation in 16 indicators: Absence of multicollinearity

Collinearity diagnostics
Indicators	Sig.	Tolerance	VIF	n	Correlation coefficient	Correlation ranking
WC	0.790	0.558	1.792	774	0.331	7
Duration of each exercise session	0.724	0.824	1.213	700	-0.172	29
Absolute value of lymphocytes	0.647	0.785	1.274	981	0.186	21
RBC	0.199	0.702	1.425	980	0.173	28
MCHC	0.114	0.831	1.203	889	0.1	71
PCT	0.476	0.750	1.334	889	0.123	48
ALT	0.265	0.554	1.806	979	0.506	1
AST/ALT	0.004	0.532	1.878	831	-0.495	2
GLO	0.360	0.880	1.137	769	0.143	38
TG	0.182	0.874	1.144	917	0.358	4
Cr/weight ratio	0.052	0.606	1.649	770	-0.255	10
HbA1c	0.008	0.758	1.319	495	0.246	13
FPSA	0.187	0.845	1.183	444	-0.194	18
Coating at left side of tongue la	0.694	0.866	1.154	924	-0.139	40
Average heart rate	0.415	0.809	1.235	860	0.233	14
Liver meridian	0.774	0.806	1.240	860	0.178	25

WC: Waist circumference; RBC: Red blood cell count; MCHC: Mean corpuscular hemoglobin concentration; PCT: Procalcitonin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GLO: Globulin; TG: Triglyceride; Cr: Creatinine; HbA1c: Glycated hemoglobin; FPSA: Free prostate-specific antigen.

Table 3 Performance comparison of each model

Models	Accuracy	Precision	Recall	F1-score
Random forest	0.83 (0.7663-0.8804)	0.82 (0.7518-0.8803)	0.83 (0.7717-0.8804)	0.81 (0.7439-0.8692)
XGBoost	0.84 (0.7989-0.9076)	0.82 (0.7987-0.9119)	0.82 (0.7820-0.8533)	0.84 (0.7741-0.8450)
Logistic regression	0.78 (0.7174-0.8370)	0.78 (0.7233-0.8379)	0.78 (0.7120-0.8370)	0.78 (0.7143-0.8340)
Support vector machine	0.78 (0.7227-0.8424)	0.77 (0.7042-0.8372)	0.78 (0.7174-0.8424)	0.78 (0.7100-0.8352)