Risk factors for biopsy‐proven advanced non‐alcoholic fatty liver disease in the Veterans Health Administration

• DOI: 10.1111/apt.14411
• Publication Date: 2017-11-08T10:16:52Z
• Authors: Y. A. Patel; E. J. Gifford; L. M. Glass; R. McNeil; M. J. Turner; B. Han; D. Provenzale; S. S. Choi; C. A. Moylan; C. M. Hunt
• Keywords: Steatohepatitis; Steatosis

Summary Background With its increasing incidence, nonalcoholic fatty liver disease ( NAFLD ) is of particular concern in the Veterans Health Administration VHA ). Aims To evaluate risk factors for advanced fibrosis biopsy‐proven VHA, to identify patients at adverse outcomes. Methods In randomly selected cases from databases (2005‐2015), we performed a retrospective case‐control study adults with biopsy‐defined or normal liver. Results Of 2091 reviewed, 399 met inclusion criteria. Normal controls (n = 65) had function. The four cohorts included: NAFL steatosis 76), steatohepatitis NASH without 68), / stage 1‐3 82), and cirrhosis 70). hepatocellular carcinoma HCC was separately identified 38). Most were older White men. any on average severely obese BMI >35 kg/m 2 Diabetes (54.4%‐79.6%) hypertension (85.8%‐100%) more common . Across , 12.3%‐19.5% enrolled diet/exercise programs 0%‐2.6% bariatric surgery. Hispanics exhibited higher rates (20.6%), while Blacks low (1.4%‐11.8%), particularly (1.4%‐2.6%). OR 11.8, P < .001) 1.4, most significant predictors fibrosis. Conclusions diabetes severe obesity increased these patients, only small proportion (~20%) surgery (~2%). These results suggest that providers should focus/tailor interventions improve outcomes, those obesity.