The hidden epidemic: Uncovering incidental fatty liver disease and its metabolic comorbidities by datamining in a hospital data lake - A real-world cohort study.

Autor: Karhiaho IP; Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland., Kurki SH; Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland; Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland., Parviainen HI; Medical Imaging Center, Department of Radiology, Helsinki University Hospital and University of Helsinki and Department of Radiology, Vaasa Central Hospital, Wellbeing Services County of Ostrobothnia, Finland., Kullamaa L; Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland., Färkkilä MA; Gastroenterology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland., Matikainen N; Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland; Research Program of Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland., Tuomi T; Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland; Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland; Research Program of Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland; Lund University, Diabetes Centre, Malmo, Sweden. Electronic address: tiinamaija.tuomi@hus.fi.
Jazyk: angličtina
Zdroj: Diabetes research and clinical practice [Diabetes Res Clin Pract] 2024 Apr; Vol. 210, pp. 111609. Date of Electronic Publication: 2024 Mar 11.
DOI: 10.1016/j.diabres.2024.111609
Abstrakt: Aims: To identify individuals with incidental fatty liver disease (FLD), and to evaluate its prevalence, metabolic co-morbidities and impact on follow-up.
Methods: We leveraged the data-lake of Helsinki Uusimaa Hospital district (Finland) with a population of 1.7 million (specialist and primary care). A phrase recognition script on abdominal imaging reports (2008-2020) identified/excluded FLD or cirrhosis; we extracted ICD-codes, laboratory and BMI data.
Results: Excluding those with other liver diseases, the prevalence of FLD was 29% (steatosis yes/no, N=61,271/155,521; cirrhosis, N=3502). The false positive and negative rates were 5-6%. Only 1.6% of the FLD cases had the ICD code recorded and 32% had undergone full clinical evaluation for associated co-morbidities. Of the 35-65-year-old individuals with FLD, 20% had diabetes, 42% prediabetes and 28% a high liver fibrosis index. FLD was independently predicted by diabetes (OR 1.56, CI 1.46-1.66, p = 2.3 * 10^-41), BMI (1.46, 1.42-1.50, p = 1.7 * 10^-154) and plasma triglyceride level (1.5, 1.43-1.57, p = 3.5 * 10^-68). Alanine aminotransferase level mildly increased (1.12, 1.08-1.16, p = 2.2 * 10^-9) and high age decreased the risk (0.92, 0.89-0.94, p = 4.65*10^-09). Half of the cases had normal ALT.
Conclusions: The incidental radiological finding of FLD is reliable and associated with metabolic risks but largely ignored, although it should lead to metabolic and hepatic follow-up.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: IK has previously worked in the administration of a private health care concern Mehiläinen and has received lecture fees from Novo Nordisk and Astra Zeneca and has received support concerning congress travel costs and participation fees from Bayer and Novo Nordisk. SK received consultancy fees from Pfizer during 2019-2020. SK received consultancy fees from Pfizer during 2019-2020. Other authors have no competing interests to declare.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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