Fatty liver awareness "strikingly low" among at-risk patients

  • Cleveland ER & al.
  • J Gen Intern Med
  • 8 Oct 2019

  • International Clinical Digest
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Takeaway

  • Awareness of nonalcoholic fatty liver disease (NAFLD) is "strikingly low" among patients with fatty liver incidentally detected during imaging for other purposes, even if they have metabolic risk factors associated with severe liver disease and death.

Why this matters

  • Raising awareness among patients and providers could increase early diagnosis and treatment.

Study design

  • Researchers studied middle-aged patients who underwent CT and completed a personal health questionnaire (N=2788; age range, 43-55 years).
  • They defined NAFLD as liver attenuation ≤51 Hounsfield units after exclusion of other causes of liver fat.
  • Patients were considered "NAFLD aware" if they reported being told by a doctor or nurse that they had "fatty liver."
  • Funding: NIH.

Key results

  • CT-defined NAFLD prevalence was 23.9% (n=667) of patients; of these, only 2.4% (n=16) were aware of an NAFLD diagnosis.
  • NAFLD-aware patients were more likely to be white (81.3% vs 53.5%; P=.03) and to have metabolic syndrome (87.5% vs 59.3%; P=.02) or hypertension (75.0% vs 50.2%; P=.05).
  • In multivariate analyses adjusting for demographics, metabolic syndrome and hypertension were predictive of higher NAFLD awareness (OR, 5.39 [95% CI 1.2–24.2] and OR, 4.99 [95% CI 1.52–16.37], respectively).

Limitations

  • The small number of NAFLD-aware patients limited statistical power for assessing multiple awareness predictors.

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