The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
The epidemiology of non-alcoholic steatohepatitis (NASH) in the United States between 2010-2020: a population-based study
Ann Hepatol. 2022 Sep-Oct;27(5):100727. doi: 10.1016/j.aohep.2022.100727. Epub 2022 Jun 11.
1Department of Hospital Medicine, Cleveland Clinic. 9500 Euclid Avenue. Cleveland, OH 44145. USA. Electronic address: Osama_hafiz@yahoo.com.
2Department of Hospital Medicine, Cleveland Clinic. 9500 Euclid Avenue. Cleveland, OH 44145. USA.
3Department of Gastroenterology and Hepatology, Cleveland Clinic. 9500 Euclid Avenue. Cleveland, OH 44145. USA.
Abstract
Introduction and objectives: Non-alcoholic steatohepatitis (NASH) is a severe form of non-alcoholic fatty liver disease (NAFLD) that can progress to liver cirrhosis, liver failure and hepatocellular carcinoma. It is the second leading cause of liver transplant in the US. We aim to investigate the prevalence, demographics and risk factors NASH patients in the US.
Patients and methods: We used a large database (Explorys IBM) that aggregates electronic health records from 26 nationwide healthcare systems. We identified adults with NASH between 2010-2020. Demographics including age, gender and race were collected. NASH risk factors including Diabetes Millets (DM), Hyperlipidemia (HLD), Hypertension (HTN) and Obesity were also collected. Cochran-Armitage test was used to assess the statistical significance of year-by-year trend. Univariable and multivariable logistic regression were used to estimate the odds ratio (OR) of risk factors.
Results: NASH annual prevalence rate increased from 1.51% in 2010 to 2.79% in 2020 (p < 0.0001). The proportion of patients with NASH by gender was 54.1% female vs 45.9% male (OR 1.04 [0.91-1.11]). Caucasian had higher odds of NASH than non-Caucasian (OR 1.42 [1.31-1.54]). NASH is strongly associated with DM and obesity (OR 18.61 [17.35-19.94]) and (OR 20.97 [17.87-23.21]), respectively. Other components of metabolic syndrome were associated with NASH to a lesser degree; HTN (OR 3.24 [3.20-3.28]) and HLD (OR 4.93 [4.85-4.01]).
Conclusion: The prevalence of NASH has significantly increased in the US in the last decade. This is likely related to the increased prevalence of risk factors as well as increased awareness of the disease.