Increasing Burden of Chronic Liver Disease Among Adolescents and Young Adults in the USA: A Silent Epidemic
Increasing Burden of Chronic Liver Disease Among Adolescents and Young Adults in the USA: A Silent Epidemic
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DOI：
10.1007/s10620-017-4492-3
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发表时间：
2017-05-01
影响因子：
3.1
通讯作者：
Alkhouri, Naim
中科院分区：
文献类型：
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作者：
Doycheva, Iliana;Watt, Kymberly D.;Alkhouri, Naim
慢性肝病（CLD）开始或建立在青少年和年轻成人（AYA）年龄组中。本研究旨在估计美国AYA中CLD患病率的趋势，并评估与CLD相关的因素。使用了1988年至2012年参加全国健康和营养检查调查的14，547名年龄在15-39岁之间的AYA（人口加权N = 68，274，386）的横断面数据。非酒精性脂肪性肝病（NAFLD）定义为体重指数25 kg/m2的受试者丙氨酸转氨酶升高（女性> 19 U/L，男性> 30 U/L）;酒精性肝病（ALD）定义为过度饮酒（男性ae 3饮酒/天，女性ae 2饮酒/天）和排除其他病因后转氨酶升高。如果HCV抗体和HCV-RNA阳性，则被认为是HCV阳性。CLD的患病率从1988-1994年的12.9%急剧增加到1999-2004年的28.5%，此后保持稳定（27.7%）。NAFLD是最常见的病因，占晚期CLD的22%。ALD的患病率多年来一直在稳步上升，而HCV一直在下降。在多变量分析中，超重/肥胖、墨西哥裔美国人、研究后期、年龄较大和男性性别与CLD的发病率较高相关。超过四分之一的美国AYA可能受到CLD的影响。在过去的三十年中，该年龄组的CLD患病率增加了一倍以上，主要是由于NAFLD患病率的上升。
Chronic liver disease (CLD) starts or becomes established in the adolescent and young adult (AYA) age group. This study aimed to estimate trends in CLD prevalence among US AYAs and to assess factors associated with CLD.Cross-sectional data from 14,547 AYAs (population-weighted N = 68,274,386) aged 15-39 years enrolled in the National Health and Nutrition Examination Survey from 1988 to 2012 were used. Nonalcoholic fatty liver disease (NAFLD) was defined as elevated alanine aminotransferase (> 19 U/L for females and > 30 U/L for males) in subjects with BMI ae 25 kg/m(2); alcoholic liver disease (ALD) as excessive alcohol use (ae3 drinks/day for men and ae2 drinks/day for women) and elevated aminotransferases after excluding alternative etiologies. Participants were considered hepatitis C virus (HCV) positive if antibody to HCV and HCV-RNA was positive.There was a sharp increase in the prevalence of CLD from 12.9% in 1988-1994 to 28.5% in 1999-2004 that remained stable after that (27.7%). NAFLD was the most common etiology accounting for 22% of all CLD in the later period. The prevalence of ALD has been steadily increasing throughout the years, while HCV has been decreasing. On multivariate analysis, being overweight/obese, Mexican-American ethnicity, later study period, older age, and male gender, were associated with higher odds of having CLD.More than one quarter of US AYAs might be affected by CLD. CLD prevalence in this age group has more than doubled over the past three decades mainly due to rise in NAFLD prevalence.