Increasing co-morbidities in chronic hepatitis B patients: experience in primary care and referral practices during 2000-2015.
Increasing co-morbidities in chronic hepatitis B patients: experience in primary care and referral practices during 2000-2015.
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DOI：
10.1038/s41424-018-0007-6
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发表时间：
2018-03-14
影响因子：
3.6
通讯作者：
Nguyen MH
中科院分区：
文献类型：
--
作者：
Liu A;Le A;Zhang J;Wong C;Wong C;Henry L;Nguyen MH
关于慢性乙型肝炎(CHB)患者肝脏和非肝脏并存的数据有限。这项研究分析了15年来评估的多中心慢性乙肝队列中的合并症的患病率。这项研究包括来自一所大学医疗中心和几家社区初级保健诊所的2734名成年美国慢性乙肝患者。数据按时间段(每个时间段的患者是唯一的，没有重叠)进行分析：2000年-2005年(n = 885)，2006年-2010年(n = 888)，2011年-2015年(n = 961)。患者通过使用诊断代码的电子查询来识别，数据通过个体图表审查确认和提取。大多数患者为男性(57.9%)和亚洲人(89.6%)。平均年龄从2000年至2005年的43.3 ± 13.4岁显著增加至2011年至2015年的49.1 ± 14.4岁(p <； 0.001)。在2000年至2005年和2011年至2015年期间，新发慢性乙肝患者中的脂肪肝发病率从1.6%上升到6.8%(p <； 0.001)。晚期肝病也有所增加(p <； 0.001)：肝硬变(12.6-24.6%)、肝脏失代偿(1.1-7.9%)和肝细胞癌(4.9-9.1%)。在非肝脏合并症中也观察到类似的趋势(p <； 0.001)。具体来说，糖尿病增加了近五倍(4.9-22.9%)，高血压增加了三倍(12.3-36.1%)，慢性肾脏疾病增加了4.5倍(4.4-19.7%)。慢性乙肝患者骨量减少和骨质疏松的患病率也有所增加：分别为5.4-13.4%(p <； 0.001)和2.9-8.7%(p <； 0.001)。这些趋势在肝脏诊所和初级保健诊所(晚期肝病除外)、治疗和未治疗的患者以及两性中都观察到。慢性乙肝患者人口正在老龄化，现在呈现出明显更多的并存。需要早期诊断和与护理相联系，以预防和减轻肝脏和非肝脏合并症。
Data on liver and non-liver co-morbidities in chronic hepatitis B (CHB) patients are limited. This study analyzes the prevalence of co-morbidities in a multicenter CHB cohort evaluated over 15 years. This study included 2734 consecutive adult American CHB patients from a university medical center and several community primary care clinics. Data were analyzed by time periods (patients in each time period were unique without overlapping): 2000–2005 (n = 885), 2006–2010 (n = 888), and 2011–2015 (n = 961). Patients were identified via electronic query using diagnosis code with data confirmed and extracted via individual chart review. Most patients were male (57.9%) and Asian (89.6%). Mean age increased significantly from 43.3 ± 13.4 years during 2000–2005 to 49.1 ± 14.4 during 2011–2015 (p < 0.001). Between 2000–2005 and 2011–2015, fatty liver disease among new CHB patients increased from 1.6 to 6.8% (p < 0.001). Advanced liver diseases also increased (p < 0.001): cirrhosis (12.6–24.6%), hepatic decompensation (1.1–7.9%), and hepatocellular carcinoma (HCC) (4.9–9.1%). Similar trends were observed for non-liver co-morbidities (p < 0.001). Specifically, diabetes increased almost fivefold (4.9–22.9%), hypertension increased threefold (12.3–36.1%) and chronic kidney disease increased 4.5-fold (4.4–19.7%). Prevalence of osteopenia and osteoporosis also increased in CHB patients: 5.4–13.4% (p < 0.001) and 2.9–8.7% (p < 0.001), respectively. These trends were observed in both liver clinics and primary care clinics (except for advanced liver disease), treated and untreated patients, and for both sexes. The CHB patient population is aging and now presents with significantly more co-morbidities. Early diagnosis and linkage to care is needed to prevent and mitigate liver as well as non-liver co-morbidities.
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影响因子：
3.8
作者：
Fabrizi, Fabrizio;Donato, Francesca M.;Messa, Piergiorgio
通讯作者：
Messa, Piergiorgio
影响因子：
3.1
作者：
Ku, Kevin C.;Li, Jiayi;Nguyen, Mindie H.
通讯作者：
Nguyen, Mindie H.
影响因子：
168.9
作者：
Schweitzer, Aparna;Horn, Johannes;Ott, Joerdis J.
通讯作者：
Ott, Joerdis J.
影响因子：
3
作者：
Boyko EJ
通讯作者：
Boyko EJ
影响因子：
2.9
作者：
Nguyen, Vincent G.;Wan, Kenton;Nguyen, Mindie H.
通讯作者：
Nguyen, Mindie H.