Clinical Advances in Liver, Pancreas, and Biliary TractPrevalence of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Among a Largely Middle-Aged Population Utilizing Ultrasound and Liver Biopsy: A Prospective Study
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Methods
Patients between the ages of 18 and 70 years who were eligible for care at Brooke Army Medical Center were considered for enrollment. Eligible patients include all active duty personnel, their dependents, and military retirees (to include spouses) who completed 20 years of active duty service or were medically retired. Patients were recruited through study handouts or posters that were located in the Primary Care Clinic waiting area. If the patient was interested in the study, the clinic
Patient Demographics
A total of 400 patients were enrolled (Figure 1) from January 2007 to March 2010. Seventy-two patients did not obtain a right upper quadrant ultrasound: 67 patients did not keep their ultrasound appointment and declined further participation in the study; 2 patients were excluded as they were discovered to have earlier fatty liver disease; 3 patients were excluded as the study questionnaire detected significant alcohol ingestion. Three hundred twenty-eight of the patients underwent a right
Discussion
The most compelling finding of this prospective study is the overall prevalence of NAFLD (46%) and NASH (12.2%) within our cohort of US middle-aged adults. The Dallas Heart Study performed in the early part of the previous decade utilized a more sensitive imaging modality and found an overall prevalence for NAFLD of 31%. Hispanics had the highest prevalence, followed by Caucasians and then African Americans.4 Our study found a higher prevalence of NAFLD using a less sensitive test and more
Acknowledgments
ClinicalTrials.gov identifier: NCT01100398.
References (29)
- et al.
Hepatic steatosis in liver transplant donors: rare phenomenon or common feature of donor population?
Transpl Proc
(2006) - et al.
Hepatic histology in obese patients undergoing bariatric surgery
J Hepatol
(2006) - et al.
Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions
Am J Gastroenterol
(1999) - et al.
Dietary habits and their relations to insulin resistance and postprandial lipemia in nonalcoholic steatohepatitis
Hepatology
(2003) - et al.
Dietary habits and nutrient intake in nonalcoholic steatohepatitis
Nutrition
(2007) - et al.
The natural history of nonalcoholic fatty liver disease: a population-based cohort study
Gastroenterology
(2005) - et al.
Long term follow up of patients with nonalcoholic fatty liver
Clin Gastroenterol Hepatol
(2009) - et al.
Prevalence and trends in obesity among US adults, 1999−2008
JAMA
(2010) - et al.
Hepatic, cardiovascular, and endocrine outcomes of the histologic subphenotype of nonalcoholic fatty liver disease
Semin Liv Dis
(2008) - et al.
The epidemiology of nonalcoholic fatty liver disease: a global perspective
Semin Liv Dis
(2008)
Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity
Hepatology
Fatty liver hepatitis (steatohepatitis) and obesity: an autopsy study with analysis of risk factors
Hepatology
Nonalcoholic steatohepatitis in donors for living donor liver transplantation
Transplantation
Living donor transplantation: histologic abnormalities found on liver biopsies of apparently healthy potential donors
J Gastroenterol Hepatol
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This article has an accompanying continuing education activity on page e12. Learning Objective: Upon completion of reading this article, successful learners will be able to identify patients likely to be at greater risk for both NAFLD and NASH.
Conflicts of interest The authors disclose no conflicts.
The opinion or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the view of the US Department of the Army or the US Department of Defense.