Real-world data reveal a diagnostic gap in non-alcoholic fatty liver disease
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide. It affects an estimated 20% of the general population, based on cohort studies of varying size and heterogeneous selection. However, the prevalence and incidence of recorded NAFLD diagnoses in unselected real-world health-care records is unknown. We harmonised health records from four major European territories and assessed age- and sex-specific point prevalence and incidence of NAFLD over the past decade.
METHODS: Data were extracted from The Health Improvement Network (UK), Health Search Database (Italy), Information System for Research in Primary Care (Spain) and Integrated Primary Care Information (Netherlands). Each database uses a different coding system. Prevalence and incidence estimates were pooled across databases by random-effects meta-analysis after a log-transformation.
RESULTS: Data were available for 17,669,973 adults, of which 176,114 had a recorded diagnosis of NAFLD. Pooled prevalence trebled from 0.60% in 2007 (95% confidence interval: 0.41-0.79) to 1.85% (0.91-2.79) in 2014. Incidence doubled from 1.32 (0.83-1.82) to 2.35 (1.29-3.40) per 1000 person-years. The FIB-4 non-invasive estimate of liver fibrosis could be calculated in 40.6% of patients, of whom 29.6-35.7% had indeterminate or high-risk scores.
CONCLUSIONS: In the largest primary-care record study of its kind to date, rates of recorded NAFLD are much lower than expected suggesting under-diagnosis and under-recording. Despite this, we have identified rising incidence and prevalence of the diagnosis. Improved recognition of NAFLD may identify people who will benefit from risk factor modification or emerging therapies to prevent progression to cardiometabolic and hepatic complications.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
BMC medicine - 16(2018), 1 vom: 13. Aug., Seite 130 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Alexander, Myriam [VerfasserIn] |
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| Links: |
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| Themen: |
Epidemiology |
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| Anmerkungen: |
Date Completed 15.10.2018 Date Revised 09.04.2022 published: Electronic CommentIn: BMC Med. 2018 Aug 24;16(1):148. - PMID 30139362 Citation Status MEDLINE |
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| doi: |
10.1186/s12916-018-1103-x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM28738974X |
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| 100 | 1 | |a Alexander, Myriam |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Real-world data reveal a diagnostic gap in non-alcoholic fatty liver disease |
| 264 | 1 | |c 2018 | |
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| 500 | |a Date Revised 09.04.2022 | ||
| 500 | |a published: Electronic | ||
| 500 | |a CommentIn: BMC Med. 2018 Aug 24;16(1):148. - PMID 30139362 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide. It affects an estimated 20% of the general population, based on cohort studies of varying size and heterogeneous selection. However, the prevalence and incidence of recorded NAFLD diagnoses in unselected real-world health-care records is unknown. We harmonised health records from four major European territories and assessed age- and sex-specific point prevalence and incidence of NAFLD over the past decade | ||
| 520 | |a METHODS: Data were extracted from The Health Improvement Network (UK), Health Search Database (Italy), Information System for Research in Primary Care (Spain) and Integrated Primary Care Information (Netherlands). Each database uses a different coding system. Prevalence and incidence estimates were pooled across databases by random-effects meta-analysis after a log-transformation | ||
| 520 | |a RESULTS: Data were available for 17,669,973 adults, of which 176,114 had a recorded diagnosis of NAFLD. Pooled prevalence trebled from 0.60% in 2007 (95% confidence interval: 0.41-0.79) to 1.85% (0.91-2.79) in 2014. Incidence doubled from 1.32 (0.83-1.82) to 2.35 (1.29-3.40) per 1000 person-years. The FIB-4 non-invasive estimate of liver fibrosis could be calculated in 40.6% of patients, of whom 29.6-35.7% had indeterminate or high-risk scores | ||
| 520 | |a CONCLUSIONS: In the largest primary-care record study of its kind to date, rates of recorded NAFLD are much lower than expected suggesting under-diagnosis and under-recording. Despite this, we have identified rising incidence and prevalence of the diagnosis. Improved recognition of NAFLD may identify people who will benefit from risk factor modification or emerging therapies to prevent progression to cardiometabolic and hepatic complications | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a NAFLD | |
| 650 | 4 | |a NASH | |
| 650 | 4 | |a Population | |
| 700 | 1 | |a Loomis, A Katrina |e verfasserin |4 aut | |
| 700 | 1 | |a Fairburn-Beech, Jolyon |e verfasserin |4 aut | |
| 700 | 1 | |a van der Lei, Johan |e verfasserin |4 aut | |
| 700 | 1 | |a Duarte-Salles, Talita |e verfasserin |4 aut | |
| 700 | 1 | |a Prieto-Alhambra, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Ansell, David |e verfasserin |4 aut | |
| 700 | 1 | |a Pasqua, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Lapi, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Rijnbeek, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Mosseveld, Mees |e verfasserin |4 aut | |
| 700 | 1 | |a Avillach, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Egger, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Kendrick, Stuart |e verfasserin |4 aut | |
| 700 | 1 | |a Waterworth, Dawn M |e verfasserin |4 aut | |
| 700 | 1 | |a Sattar, Naveed |e verfasserin |4 aut | |
| 700 | 1 | |a Alazawi, William |e verfasserin |4 aut | |
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