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Exploring factors related to clinically advanced fibrosis in patients with nonalcoholic fatty liver disease or nonalcoholic steatohepatitis.
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- Author(s): Yu A;Yu A;Yu A; Ritenour A; Ritenour A; Vincent J; Vincent J; Park C; Park C; Rascati K; Rascati K; Godley P; Godley P
- Source:
Postgraduate medicine [Postgrad Med] 2024 Jan; Vol. 136 (1), pp. 14-21. Date of Electronic Publication: 2023 Nov 30.- Publication Type:
Observational Study; Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: Informa Healthcare Country of Publication: England NLM ID: 0401147 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1941-9260 (Electronic) Linking ISSN: 00325481 NLM ISO Abbreviation: Postgrad Med Subsets: MEDLINE
- Publication Information: Publication: 2015- : London : Informa Healthcare
Original Publication: New York : Vendome Group, -2006 - Subject Terms: Non-alcoholic Fatty Liver Disease*/epidemiology ; Non-alcoholic Fatty Liver Disease*/diagnosis ; Diabetes Mellitus, Type 2*/epidemiology; Male ; Humans ; Aged ; United States ; Liver Cirrhosis/diagnosis ; Retrospective Studies ; Cross-Sectional Studies ; Medicare ; Obesity/complications ; Liver/pathology
- Abstract: Objectives: To describe the clinical profile of nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH) patients in a Texas integrated delivery network (IDN) and elucidate the local relationship between patient factors and the risk of advanced fibrosis.
Methods: This observational, retrospective, cross-sectional study utilized existing data from the electronic health record at a large Texas IDN. Data was collected during the study period from 1 January 2019, to 1 March 2023. Patient characteristics, comorbidities, labs, and medication orders were collected from the most recent encounter in which a Fibrosis-4 (FIB-4) score could be calculated. Chi square tests and analysis of variance (ANOVA) tests were conducted to evaluate differences among the three fibrosis risk categories. Ordinal logistic regression was utilized to assess associations between select variables and a higher risk of advanced fibrosis.
Results: A total of 56,253 patients were included in the study. 34,839 (61.9%) were Low-Risk 15,578 (27.7%) were Intermediate-Risk, and 5,836 (10.4%) were High-Risk of advanced fibrosis. Results showed that up to 70.4% of patients within a risk group were obese. Only 49.5% of patients in the High-Risk group had at least one gastroenterologist or hepatologist visit. Males, Medicare patients, former smokers, and those with hypertension, type 2 diabetes, and chronic kidney disease were associated with a higher risk of advanced fibrosis.
Conclusion: This study highlights the need for early screening and proactive management of metabolic risk factors for patients with NAFLD/NASH. The findings indicate a notable prevalence of obesity in the study population, a need for specialist referral for those at High-Risk of advanced fibrosis, and the importance of routine labs to evaluate metabolic factors. Primary care providers may be ideal providers to target these interventions and address this care need. - Contributed Indexing: Keywords: FIB-4; NAFLD; NASH; diabetes; fibrosis; metabolic; obesity; preventative care
- Publication Date: Date Created: 20231130 Date Completed: 20240307 Latest Revision: 20240307
- Publication Date: 20240307
- Accession Number: 10.1080/00325481.2023.2288560
- Accession Number: 38032542
- Source:
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