Prevalence of liver fibrosis in the general population (the LiverScreen project): a multinational European cohort study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Graupera Isabel, Thiele Maja, Castera Laurent, Pera Guillem, Piano Salvatore, Sòria Anna, Fabrellas Núria, Toran Pere, Chacon Carla, Bech Katrine T, Schnefeld Helle Lindholm, Tonon Marta, Incicco Simone, Moussy Joël, Lévy Vincent, Madir Anita, Kukic Sandro, Jan Havaj Daniel, Adamcova-Selcanova Svetlana, Pustjens Jesse, van Kleef Laurens A, Jiménez-Masip Alba, Pagès Laura, Zoncapè Mirko, Weber Susanne N, Galle Peter R, Harris Rebecca, Ibáñez-Samaniego Luis, Morillas Rosa M, Diaz Alba, Detlefsen Sönke, Serra-Burriel Miquel, Arslanow Anita, Andersen Peter, Pich Judit, Bonfill Eva, Korenjak Marko, Fournier-Poizat Céline, Llorca Anne, Gourmelon Marie-Caroline, de Koning Harry J, Pérez-Guasch Martina, Thu Ma Ann, Juanola Adrià, Pose Elisa, Arteaga Ingrid, Villesen Ida, Hansen Johanne Kragh, Calvino Valeria, Gagliardi Roberta, Boutouria Bahija, Pastrovic Frane, Kujundzic Petra Dinjar, Zilincanova Daniela, Sulejova Karolina Kristina, Rojo Diego, de Knegt Robert J, Melo Maykon Diego, Torrejón Antonio, Hernández-Ibáñez Rosario, Hoyo Jordi, Muñoz Laura, López-Martos Raquel, Griffin Simon J, Manns Michael, Karlsen Tom H, Newsome Phil N, Kamath Patrick S, Bañares Rafael, Guha Indra N, Schattenberg Jörn M, Lammert Frank, Tsochatzis Emmanuel, Brouwer Willem P, Pericàs Juan M, Skladany Lubomir, Grgurevic Ivica, Roulot Dominique, Angeli Paolo, Krag Aleksander, Caballeria Llorenç, Ginès Pere, LiverScreen Consortium Investigators
Аннотация
METHODS: We enrolled individuals from the general population who were aged 40 years and older across 35 sites, including primary health centres and screening units, and their 16 affiliated tertiary hospitals in nine European countries. Liver fibrosis was estimated using the liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE). A positive test was defined as an LSM of 8 kPa and greater or an alanine aminotransferase concentration of at least 1·5 the upper limit of normal, or a combination of both. Individuals with at least one criterion were referred for hepatology consultation to confirm chronic liver disease with fibrosis. The primary outcome was the prevalence of LSM of 8 kPa and greater.
FINDINGS: We enrolled 30 199 individuals (mean age 58 years; 57% [17 203 of 30 199] women, 89% [24 440 of 27 481]White) from nine European countries. Metabolic factors were present in 70% (21 084 of 30 024) of participants, and 59% (15 107 of 25 488) of participants reported alcohol use, with 6·1% (1771 of 29 081) of participants reporting harmful consumption. The positive screening rate was 6·9% with a prevalence of 4·6% with an LSM of 8 kPa and greater. Elevated LSM was strongly associated with obesity, type 2 diabetes, and harmful alcohol use. Of the participants referred, 61% (1491 of 2457) completed a hepatology evaluation, and chronic liver disease with fibrosis was confirmed in 32% (477 of 1491) of participants, yielding an overall estimated prevalence of 1·6% (477 of 30 199). Steatotic liver disease accounted for 93% (443 of 477) of cases.
INTERPRETATION: Undiagnosed liver fibrosis is common in the general population in Europe and is primarily driven by metabolic factors and alcohol consumption. Early detection is pivotal as it could allow personalised interventions that can prevent progression to cirrhosis and complications.
FUNDING: The European Commission, Fondo de Investigación Sanitaria de Salud, the Spanish Ministry of Economy, Industry, and Competitiveness, and the European Regional Development Fund.