PMID- 31366455
OWN - NLM
STAT- MEDLINE
DCOM- 20200414
LR  - 20200414
IS  - 1468-3288 (Electronic)
IS  - 0017-5749 (Linking)
VI  - 69
IP  - 3
DP  - 2020 Mar
TI  - Epidemiology of chronic liver diseases in the USA in the past three decades.
PG  - 564-568
LID - 10.1136/gutjnl-2019-318813 [doi]
AB  - OBJECTIVE: Given significant advances in treatment of viral hepatitis and the 
      growing epidemic of obesity, the burden of the different types of liver diseases 
      in the USA may be changing. Our aim was to assess the shift in the prevalence of 
      different liver disease aetiologies in the USA over the past three decades. 
      DESIGN: National Health and Nutrition Examination Surveys (NHANES; 
      cross-sectional 1988-1994 and 1999-2016) were used. RESULTS: A total of 58 731 
      adults from NHANES (1988-2016) were included. Over the study period, the 
      prevalence of chronic hepatitis B and alcoholic liver disease remained stable: 
      0.3%-0.4% and 0.8%-1.0%, respectively (p>0.05). The prevalence of chronic 
      hepatitis C decreased nearly twofold: 1.6% in 1988-1994 to 0.9% in 2013-2016 
      (p=0.03). In contrast, the prevalence of non-alcoholic fatty liver disease 
      (NAFLD; by US-Fatty Liver Index) increased from 20.0% (1988-1994) to 28.3% 
      (1999-2004) to 33.2% (2009-2012) and 31.9% (2013-2016) (p<0.0001). Furthermore, 
      steady increases were observed in the rates of obesity (22.2% in 1988-1994 to 
      31.0% in 1999-2004 to 38.9% in 2013-2016), type 2 diabetes mellitus (T2DM) (from 
      7.2% to 8.2% to 13.5% same years), insulin resistance and hypertension (all 
      p<0.0001). Yearly trend analyses showed that the only LD with consistently 
      increasing prevalence was NAFLD (trend p=0.01). Multivariable regression analysis 
      showed that obesity (OR 10.4; 95% CI 9.5 to 11.3) and T2DM (OR 3.7; 95% CI 3.2 to 
      4.2) were the major independent predictors of NAFLD. CONCLUSIONS: Over the past 
      30 years in the USA, NAFLD is the only liver disease with growing prevalence, 
      synchronous with the increasing rates of obesity and T2DM.
CI  - (c) Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Younossi, Zobair M
AU  - Younossi ZM
AUID- ORCID: 0000-0001-9313-577X
AD  - Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls 
      Church, Virginia, USA zobair.younossi@inova.org.
AD  - Department of Medicine, Center For Liver Disease, Inova Fairfax Hospital, Falls 
      Church, Virginia, USA.
FAU - Stepanova, Maria
AU  - Stepanova M
AD  - Department of Statistical Services, Center for Outcomes Research in Liver 
      Diseases, Washington, DC, USA.
FAU - Younossi, Youssef
AU  - Younossi Y
AD  - Department of Statistical Services, Center for Outcomes Research in Liver 
      Diseases, Washington, DC, USA.
FAU - Golabi, Pegah
AU  - Golabi P
AD  - Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls 
      Church, Virginia, USA.
AD  - Department of Medicine, Center For Liver Disease, Inova Fairfax Hospital, Falls 
      Church, Virginia, USA.
FAU - Mishra, Alita
AU  - Mishra A
AD  - Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls 
      Church, Virginia, USA.
AD  - Department of Medicine, Center For Liver Disease, Inova Fairfax Hospital, Falls 
      Church, Virginia, USA.
FAU - Rafiq, Nila
AU  - Rafiq N
AD  - Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls 
      Church, Virginia, USA.
AD  - Department of Medicine, Center For Liver Disease, Inova Fairfax Hospital, Falls 
      Church, Virginia, USA.
FAU - Henry, Linda
AU  - Henry L
AD  - Department of Statistical Services, Center for Outcomes Research in Liver 
      Diseases, Washington, DC, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190731
PL  - England
TA  - Gut
JT  - Gut
JID - 2985108R
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Chronic Disease
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - Female
MH  - Hepatitis B, Chronic/epidemiology
MH  - Hepatitis C, Chronic/epidemiology
MH  - Humans
MH  - Hypertension/epidemiology
MH  - Insulin Resistance
MH  - Liver Diseases/*epidemiology
MH  - Liver Diseases, Alcoholic/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Non-alcoholic Fatty Liver Disease/epidemiology
MH  - Nutrition Surveys
MH  - Obesity/*epidemiology
MH  - Prevalence
MH  - Risk Factors
MH  - United States/epidemiology
MH  - Young Adult
OTO - NOTNLM
OT  - diabetes
OT  - epidemiology
OT  - non-alcoholic fatty liver disease
OT  - obesity
OT  - trends
COIS- Competing interests: None declared.
EDAT- 2019/08/02 06:00
MHDA- 2020/04/15 06:00
CRDT- 2019/08/02 06:00
PHST- 2019/03/29 00:00 [received]
PHST- 2019/07/09 00:00 [revised]
PHST- 2019/07/12 00:00 [accepted]
PHST- 2019/08/02 06:00 [pubmed]
PHST- 2020/04/15 06:00 [medline]
PHST- 2019/08/02 06:00 [entrez]
AID - gutjnl-2019-318813 [pii]
AID - 10.1136/gutjnl-2019-318813 [doi]
PST - ppublish
SO  - Gut. 2020 Mar;69(3):564-568. doi: 10.1136/gutjnl-2019-318813. Epub 2019 Jul 31.