Real-world data reveal a diagnostic gap in non-alcoholic fatty liver disease

• DOI: 10.1186/s12916-018-1103-x
• Publication Date: 2018-07-31T08:41:03Z
• Authors: Myriam Alexander; A. Katrina Loomis; Jolyon Fairburn-B...; Johan van der Lei; Talita Duarte-Salles; Daniel Prieto-Alh...; David Ansell; Alessandro Pasqua; Francesco Lapi; Peter Rijnbeek; Mees Mosseveld; Paul Avillach; Peter Egger; Stuart Kendrick; Dawn M. Waterworth; Naveed Sattar; William Alazawi
• Keywords: Male; Databases, Factual; Epidemiology; Incidence; Population; EMC NIHES-03-77-02; NASH; R; Middle Aged; 3. Good health; Non-alcoholic Fatty Liver Disease; Risk Factors; NAFLD; Disease Progression; Prevalence; Medicine; Humans; Female; Research Article

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of worldwide. It affects an estimated 20% general population, based on cohort studies varying size and heterogeneous selection. However, prevalence incidence recorded NAFLD diagnoses in unselected real-world health-care records unknown. We harmonised health from four major European territories assessed age- sex-specific point over past decade.Data were extracted The Health Improvement Network (UK), Search Database (Italy), Information System for Research Primary Care (Spain) Integrated (Netherlands). Each database uses a different coding system. Prevalence estimates pooled across databases by random-effects meta-analysis after log-transformation.Data available 17,669,973 adults, which 176,114 had diagnosis NAFLD. Pooled trebled 0.60% 2007 (95% confidence interval: 0.41-0.79) to 1.85% (0.91-2.79) 2014. Incidence doubled 1.32 (0.83-1.82) 2.35 (1.29-3.40) per 1000 person-years. FIB-4 non-invasive estimate fibrosis could be calculated 40.6% patients, whom 29.6-35.7% indeterminate or high-risk scores.In largest primary-care record study its kind date, rates are much lower than expected suggesting under-diagnosis under-recording. Despite this, we have identified rising diagnosis. Improved recognition may identify people who will benefit risk factor modification emerging therapies prevent progression cardiometabolic hepatic complications.