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Presence and severity of non-alcoholic fatty liver disease in a large prospective primary care cohort
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Armstrong, Matthew J., Houlihan, Diarmaid D., Bentham, Louise, Shaw, Jean C., Cramb, Robert, Olliff, Simon, Gill, Paramjit, Neuberger, James M., Lilford, Richard and Newsome, Philip N. (2012) Presence and severity of non-alcoholic fatty liver disease in a large prospective primary care cohort. Journal of Hepatology, 56 (1). pp. 234-240. doi:10.1016/j.jhep.2011.03.020
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Official URL: http://dx.doi.org/10.1016/j.jhep.2011.03.020
Abstract
Background & Aims
Non-alcoholic fatty liver disease (NAFLD) is a common cause of abnormal LFTs in primary care, but there are no data defining its contribution nor reporting the range of NAFLD severity in this setting. This study seeks to calculate the range of disease severity of NAFLD in a primary care setting.
Methods
Adult patients with incidental abnormal LFTs, in the absence of a previous history, or current symptoms/signs of liver disease were prospectively recruited from eight primary care practices in Birmingham. NAFLD was diagnosed as fatty liver on ultrasound, negative serological liver aetiology screen, and alcohol consumption ⩽30 and ⩽20 g/day in males and females, respectively. The NAFLD Fibrosis Score (NFS) was calculated to determine the presence or absence of advanced liver fibrosis in subjects identified with NAFLD.
Results
Data from 1118 adult patients were analysed. The cause of abnormal LFTs was identified in 55% (614/1118) of subjects, with NAFLD (26.4%; 295/1118) and alcohol excess (25.3%; 282/1118) accounting for the majority. A high NFS (>0.676) suggesting the presence of advanced liver fibrosis was found in 7.6% of NAFLD subjects, whereas 57.2% of NAFLD patients had a low NFS (<−1.455) allowing advanced fibrosis to be confidently excluded.
Conclusions
NAFLD is the commonest cause of incidental LFT abnormalities in primary care (26.4%), of whom 7.6% have advanced fibrosis as calculated by the NFS. This study is the first of its kind to highlight the burden of NAFLD in primary care and provide data on disease severity in this setting.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Journal of Hepatology | ||||
| Publisher: | Elsevier BV | ||||
| ISSN: | 0168-8278 | ||||
| Official Date: | 2012 | ||||
| Dates: |
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| Volume: | 56 | ||||
| Number: | 1 | ||||
| Page Range: | pp. 234-240 | ||||
| DOI: | 10.1016/j.jhep.2011.03.020 | ||||
| Status: | Peer Reviewed | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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