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Liver
Original research
Cross-sectional study of the prevalence of chronic liver disease risk factors and liver fibrosis in a remotely living Indigenous Australian population
  1. Alan J Wigg1,2,
  2. Sumudu Narayana3,
  3. Michael Nugent4,
  4. Arlene Ackland4,
  5. Damian Riessen4,
  6. Benjamin L Wigg5,
  7. Kate R Muller1,3,
  8. Jeyamani Ramachandran3,
  9. Richard J Woodman1
  1. 1College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
  2. 2Southern Adelaide Local Health Service, Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia
  3. 3Hepatology and Liver Transplantation Medicine Unit, Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia
  4. 4Umoona Tjutagku Health Service Aboriginal Corporation, Coober Pedy, South Australia, Australia
  5. 5Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
  1. Correspondence to Professor Alan J Wigg; alan.wigg{at}sa.gov.au

Abstract

Objectives Remotely living Indigenous Australians have a disproportionate mortality from cirrhosis and hepatocellular cancer (HCC). However, there are no local population studies examining the prevalence of chronic liver disease (CLD) in remote communities. The main aims of this study were therefore to study a remote Indigenous population to determine the prevalence of CLD risk factors and the prevalence of significant fibrosis as defined by an Fibrosis-4 (FIB-4) score of ≥2.67.

Methods The study design was a retrospective analysis of an electronic medical record database of a remote Aboriginal community-controlled health service. The setting was an Aboriginal community-controlled health service located in a remote South Australian town with a 15% Indigenous Australian population. Participants were all adult Indigenous Australians between the ages of 35 and 65 years.

Results 83.9% of the study population had at least one CLD risk factor and 45% of the population had multiple CLD risk factors. The most prevalent risk factors were alcohol misuse, diabetes and obesity. 3.7% of the population had a high risk of significant fibrosis with an FIB-4 score≥2.67. Each additional CLD risk factor was associated with a 12.3% increase in FIB-4 mean (p=0.001).

Conclusions CLD risk factors and significant liver fibrosis were highly prevalent in this population. Integrating simple liver screening tests into adult health checks has the potential to detect CLD at an early and treatable stage and to reduce the high morbidity and mortality from cirrhosis and HCC experienced by remotely living Indigenous Australians.

  • ALCOHOLIC LIVER DISEASE
  • CHRONIC HEPATITIS
  • FATTY LIVER
  • FIBROSIS
  • HEPATOCELLULAR CARCINOMA

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/flgastro-2024-102650

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Contributors AJW designed the study, wrote the first draft and is the guarantor. SN coordinated study and ethics/governance approvals and collected data. RJW performed the major statistical analyses. AA and DR facilitated local governance approvals. BLW performed basic statistical analyses. All authors were involved in critical reviews of manuscript.

    • Funding The authors acknowledge funding from the Gastroenterology of Australia (2022 GESA Members’ Grant) and the Southern Adelaide Local Health Network (SALHN Enquiry Grant 2022).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.