The Epidemiology of Newly Diagnosed Chronic Liver Disease in Gastroenterology Practices in the United States: Results From Population-Based Surveillance
The Epidemiology of Newly Diagnosed Chronic Liver Disease in Gastroenterology Practices in the United States: Results From Population-Based Surveillance
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DOI：
10.1111/j.1572-0241.2008.02071.x
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发表时间：
2008-11-01
影响因子：
9.8
通讯作者：
Sofair, Andre N.
中科院分区：
文献类型：
--
作者：
Bell, Beth P.;Manos, M. Michele;Sofair, Andre N.
结论：慢性肝病（CLD）是发病和死亡的重要原因，但流行病学尚未得到很好的描述。我们进行了前瞻性的基于人群的监测，以估计新诊断的CLD发病率，表征病因分布，并确定疾病stage.METHODS：我们确定了1999年至2001年期间新诊断的CLD病例，这些病例见于康涅狄格州纽黑文县、俄勒冈州穆特诺玛县、康涅狄格州纽黑文县和俄勒冈州蒙特诺玛县的任何胃肠病学实践中。和北方加州Kaiser Permanente医疗保健计划（KPMCP，奥克兰，加州[总人口148万]）。我们将CLD定义为至少持续6个月的肝脏检查异常或CLD的病理、临床或放射学证据。结果：我们确定了2,353例新诊断的CLD患者（63.9例/100,000人口），其中包括1,225例丙型肝炎患者（33.2例/100,000）。45-54岁男性丙肝发病率最高（111.3/10万）。在1,040例入组患者中，中位年龄为48岁（范围19-86岁）。丙型肝炎，单独（442 [42%]）或与酒精相关的肝病（ALD）（228 [22%]）相结合，占病例的三分之二。其他病因包括非酒精性脂肪肝（NAFLD，95例[9%]）、ALD（82例[8%]）和B型肝炎（36例[3%]）。其他已确定的病因，
OBJECTIVES: Chronic liver disease (CLD) is an important cause of morbidity and mortality, but the epidemiology is not well described. We conducted prospective population-based surveillance to estimate newly diagnosed CLD incidence, characterize etiology distribution, and determine disease stage.METHODS: We identified cases of CLD newly diagnosed during 1999-2001 among adult county residents seen in any gastroenterology practice in New Haven County, Connecticut; Multnomah County, Oregon; and Northern California Kaiser Permanente Medical Care Program (KPMCP, Oakland, California [total population 1.48 million]). We defined CLD as abnormal liver tests of at least 6 months' duration or pathologic, clinical, or radiologic evidence of CLD. Consenting patients were interviewed, a blood specimen obtained, and the medical record reviewed.RESULTS: We identified 2,353 patients with newly diagnosed CLD (63.9 cases/100,000 population), including 1,225 hepatitis C patients (33.2 cases/100,000). Men aged 45-54 yr had the highest hepatitis C incidence rate (111.3/100,000). Among 1,040 enrolled patients, the median age was 48 yr (range 19-86 yr). Hepatitis C, either alone (442 [42%]) or in combination with alcohol-related liver disease (ALD) (228 [22%]), accounted for two-thirds of the cases. Other etiologies included nonalcoholic fatty liver disease (NAFLD, 95 [9%]), ALD (82 [8%]), and hepatitis B (36 [3%]). Other identified etiologies each accounted for