Prevalence of chronic liver disease and cirrhosis by underlying cause in understudied ethnic groups: The multiethnic cohort.
Prevalence of chronic liver disease and cirrhosis by underlying cause in understudied ethnic groups: The multiethnic cohort.
复制标题
DOI：
10.1002/hep.28677
复制
发表时间：
2016-12
期刊：
影响因子：
--
通讯作者：
Noureddin M
中科院分区：
文献类型：
--
作者：
Setiawan VW;Stram DO;Porcel J;Lu SC;Le Marchand L;Noureddin M
慢性肝病（CLD）和肝硬化是美国发病率和死亡率的主要来源。人们对这两种疾病在美国少数民族人群中的流行病学知之甚少。在多种族队列中，我们通过潜在病因检查了非裔美国人、夏威夷原住民、日裔美国人、拉丁美洲人和白人中CLD和肝硬化的患病率。在1999年至2012年期间，使用医疗保险索赔在付费服务参与者中确定CLD和肝硬化病例（n=106,458）。我们使用ICD-9编码、体重指数、糖尿病史和问卷中的酒精消费来确定潜在的病因。共发现5,783例CLD（3,575例无肝硬化CLD和2,208例肝硬化CLD）。CLD的患病率从非裔美国人和夏威夷原住民的3.9%到白人的4.1%，拉丁美洲人的6.7%和日本人的6.9%不等。非酒精性脂肪性肝病（NAFLD）是所有族群中最常见的CLD原因（52%），其次是酒精性肝病（ALD）（21%）。NAFLD是整个队列中最常见的肝硬化原因。按种族划分，NALFD是日裔美国人、夏威夷原住民和拉丁美洲人肝硬化的最常见原因，占32%。ALD是白人肝硬化最常见的原因（38.2%），而丙型肝炎病毒是非洲裔美国人最常见的原因（29.8%）。我们通过潜在病因显示了CLD和肝硬化患病率的种族/民族差异。在整个队列中，NAFLD是CLD和肝硬化最常见的原因。日裔美国人和夏威夷原住民中NAFLD的高患病率是一个新发现，阐明其原因的研究是有必要的。
Chronic liver disease (CLD) and cirrhosis are major sources of morbidity and mortality in the United States. Little is known about the epidemiology of these two diseases in ethnic minority populations in the United States. We examined the prevalence of CLD and cirrhosis by underlying etiologies among African Americans, Native Hawaiians, Japanese Americans, Latinos and whites in the Multiethnic Cohort. CLD and cirrhosis cases were identified using Medicare claims between 1999 and 2012 among the fee-for-service participants (n=106,458). We used ICD-9 codes, body mass index, history of diabetes mellitus and alcohol consumption from questionnaires to identify underlying etiologies. A total of 5,783 CLD (3,575 CLD without cirrhosis and 2,208 cirrhosis) cases were identified. The prevalence of CLD ranged from 3.9% in African Americans and Native Hawaiians to 4.1% in whites, 6.7% in Latinos and 6.9% in Japanese. Nonalcoholic fatty liver disease (NAFLD) was the most common cause of CLD in all ethnic groups combined (52%), followed by alcoholic liver disease (ALD) (21%). NAFLD was the most common cause of cirrhosis in the entire cohort. By ethnicity, NALFD was the most common cause of cirrhosis in Japanese Americans, Native Hawaiians, and Latinos, accounting for 32% of cases. ALD was the most common cause of cirrhosis in whites (38.2%), while hepatitis C virus was the most common cause in African Americans (29.8%). We showed racial/ethnic variations in the prevalence of CLD and cirrhosis by underlying etiology. NAFLD is the most common cause of CLD and cirrhosis in the entire cohort. The high prevalence of NAFLD among Japanese Americans and Native Hawaiians are novel findings and studies elucidating the causes are warranted.