Screening for undiagnosed non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH): A population-based risk factor assessment using vibration controlled transient elastography (VCTE).
Screening for undiagnosed non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH): A population-based risk factor assessment using vibration controlled transient elastography (VCTE).
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DOI：
10.1371/journal.pone.0260320
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Chang HE
中科院分区：
文献类型：
--
作者：
Eskridge W;Vierling JM;Gosbee W;Wan GA;Hyunh ML;Chang HE
筛查未确诊的非酒精性脂肪性肝病和非酒精性脂肪性肝炎（SUNN）研究是一项基于人群的筛查研究，旨在提供概念证明，以鼓励对这种非传染性疾病进行社区级筛查和检测。目前的筛查指南不建议对无症状人群进行非酒精性脂肪肝（NAFLD）的常规筛查，因此不鼓励提供者积极寻找疾病，即使是高危患者。本研究旨在确定一个自我选择的无症状个体队列是否具有基于振动控制瞬态弹性成像（VCTE）和受控衰减参数（CAP）的评分，这些评分与风险因素显著相关，以表明应推荐对高危患者进行常规筛查。该研究在德克萨斯州休斯顿和加尔维斯顿县招募了1，070名自我选择的参与者，其中940人被纳入最终分析。使用预筛选调查确定合格性。基于VCTE的评分分析脂肪变性和纤维化水平。57%的研究人群表现出脂肪变性而无纤维化，表明NAFLD，而16%表现出脂肪变性和纤维化，表明NASH。具有统计学意义的危险因素包括与代谢综合征、种族和年龄相关的因素，而具有统计学意义的保护因素包括某些食物的摄入和运动。这项研究的结果表明，即使在没有症状的情况下，也应对高风险个体进行NAFLD筛查，并且以社区为基础的筛查是一种有效的工具，特别是在缺乏针对提供者的积极指导方针的情况下。
The screening for undiagnosed non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (SUNN) study was a population-based screening study that aimed to provide proof of concept to encourage community-level screening and detection for this non-communicable disease. Current screening guidelines do not recommend the routine screening of nonalcoholic fatty liver disease (NAFLD) for asymptomatic populations, so providers are not encouraged to actively seek disease, even in high-risk patients. This study sought to determine whether a self-selecting cohort of asymptomatic individuals would have scores based on vibration controlled transient elastography (VCTE) and controlled attenuation parameter (CAP) significantly correlated to risk factors to suggest that routine screening for high-risk patients should be recommended. The study recruited 1,070 self-selected participants in Houston and Galveston County, Texas, 940 of which were included in final analysis. A pre-screening survey was used to determine eligibility. VCTE-based scores analyzed steatosis and fibrosis levels. Fifty-seven percent of the study population demonstrated steatosis without fibrosis, suggesting NAFLD, while 16% demonstrated both steatosis and fibrosis, suggesting NASH. Statistically significant risk factors included factors related to metabolic syndrome, race, and age, while statistically significant protective factors included consumption of certain foods and exercise. The findings of this study suggest that high-risk individuals should be screened for NAFLD even in the absence of symptoms and that community-based screenings are an effective tool, particularly in the absence of proactive guidelines for providers.
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