Ethnicity and the diagnosis gap in liver disease: a population-based study.
Ethnicity and the diagnosis gap in liver disease: a population-based study.
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DOI：
10.3399/bjgp14x682273
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发表时间：
2014-11
期刊：
影响因子：
--
通讯作者：
Foster GR
中科院分区：
文献类型：
--
作者：
Alazawi W;Mathur R;Abeysekera K;Hull S;Boomla K;Robson J;Foster GR
肝病是全球发病率和死亡率的主要原因。在初级保健中进行大量肝功能检查（LFT），肝脏生化异常是常见的发现。非酒精性脂肪肝（NAFLD）是慢性肝损伤最常见的原因。代谢综合征在南亚人群中很常见，是NAFLD的一个重要危险因素。据推测，异常LFT患者的数量与记录的肝脏诊断之间存在很大的差距，并且NAFLD在南亚种族群体的成年人中更常见。一项对690 683名成年人进行的横断面研究，这些成年人在一个具有高度种族多样性的地区从事共同的一般实践。从计算机化的初级保健医疗记录中提取LFT、肝脏疾病和护理措施过程的数据。对218032例患者进行了LFT，其中31627例血清转氨酶升高。异常LFT的患病率在孟加拉族中最高。在LFT异常的患者中，88.4%没有编码的肝脏诊断。NAFLD是最常见的肝病，在孟加拉国患者中最常见。在多变量分析中，NAFLD的独立危险因素包括孟加拉民族、糖尿病、BMI升高、高血压和高胆固醇血症。异常LFT在人群中很常见，但调查不足，往往无法诊断。孟加拉民族是NAFLD的重要独立风险因素。
Liver disease is a major cause of morbidity and mortality worldwide. Large numbers of liver function tests (LFTs) are performed in primary care, with abnormal liver biochemistry a common finding. Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver injury. Metabolic syndrome, common in people from South Asia, is an important risk factor for NAFLD. It is hypothesised that a large gap exists between numbers of patients with abnormal LFTs and those with recorded liver diagnoses, and that NAFLD is more common among adults of South Asian ethnic groups. A cross-sectional study of 690 683 adults in coterminous general practices in a region with high ethnic diversity. Data were extracted on LFTs, liver disease, and process of care measures from computerised primary care medical records. LFTs were performed on 218 032 patients, of whom 31 627 had elevated serum transaminases. The prevalence of abnormal LFTs was highest among individuals of Bangladeshi ethnicity. Of the patients with abnormal LFTs, 88.4% did not have a coded liver diagnosis. NAFLD was the most frequently recorded liver disease and was most common among Bangladeshi patients. In a multivariate analysis, independent risk factors for NAFLD included Bangladeshi ethnicity, diabetes, raised BMI, hypertension, and hypercholesterolaemia. Abnormal LFTs are common in the population, but are underinvestigated and often remain undiagnosed. Bangladeshi ethnicity is an important independent risk factor for NAFLD.