The epidemiology of non-alcoholic steatohepatitis (NASH) in the United States between 2010-2020: a population-based study |
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Authors: | Osama Hamid Ahmed Eltelbany Abdul Mohammed Khaled Alsabbagh Alchirazi Sushrut Trakroo Imad Asaad |
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Institution: | 1. Department of Hospital Medicine, Cleveland Clinic. 9500 Euclid Avenue. Cleveland, OH 44145. USA;2. Department of Gastroenterology and Hepatology, Cleveland Clinic. 9500 Euclid Avenue. Cleveland, OH 44145. USA |
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Abstract: | Introduction and objectivesNon-alcoholic steatohepatitis (NASH) is a severe form of non-alcoholic fatty liver disease (NAFLD) that can progress to liver cirrhosis, liver failure and hepatocellular carcinoma. It is the second leading cause of liver transplant in the US. We aim to investigate the prevalence, demographics and risk factors NASH patients in the US.Patients and methodsWe used a large database (Explorys IBM) that aggregates electronic health records from 26 nationwide healthcare systems. We identified adults with NASH between 2010-2020. Demographics including age, gender and race were collected. NASH risk factors including Diabetes Millets (DM), Hyperlipidemia (HLD), Hypertension (HTN) and Obesity were also collected. Cochran-Armitage test was used to assess the statistical significance of year-by-year trend. Univariable and multivariable logistic regression were used to estimate the odds ratio (OR) of risk factors.ResultsNASH annual prevalence rate increased from 1.51% in 2010 to 2.79% in 2020 (p < 0.0001). The proportion of patients with NASH by gender was 54.1% female vs 45.9% male (OR 1.04 0.91-1.11]). Caucasian had higher odds of NASH than non-Caucasian (OR 1.42 1.31-1.54]). NASH is strongly associated with DM and obesity (OR 18.61 17.35-19.94]) and (OR 20.97 17.87-23.21]), respectively. Other components of metabolic syndrome were associated with NASH to a lesser degree; HTN (OR 3.24 3.20-3.28]) and HLD (OR 4.93 4.85-4.01]).ConclusionThe prevalence of NASH has significantly increased in the US in the last decade. This is likely related to the increased prevalence of risk factors as well as increased awareness of the disease. |
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Keywords: | Corresponding Author: Osama Hamid MD MRCPI 9500 Euclid Avenue Cleveland OH 44145 Phone: +1-440-870-1377 Non-alcoholic steatohepatitis Epidemiology Explorys Obesity Diabetes NASH Non-alcoholic Steatohepatitis NAFLD Non-alcoholic fatty liver disease NAFL Non-alcoholic fatty liver MAFLD Metabolic dysfunction-associated fatty liver disease OR Odds ratio CI Confidence interval DM Diabetes Millets HLD Hyperlipidemia HTN Hypertension BMI Body mass index EHR Electronic health record AASLD American association for the study of liver disease MRE Magnetic Resonance Elastography FIB-4 fibrosis-4 index SNOMED-CT systemized nomenclature of clinical medical terms ICD International Classification of Disease HIPPA Health Insurance Portability and Accountability Act HITECH Health Information Technology for Economic and Clinical Health Act NFS the NAFLD fibrosis score FDA US Food and Drug Administration AAFP American Academy of Family Physicians |
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