07 May Over 11 Million US Adults Have Alcoholic Liver Disease
MedicalResearch.com Interview with:
Robert Wong, MD, MS, FACG
Assistant Clinical Professor of Medicine
Director, GI Education & Research
Highland Hospital I A member of Alameda Health System
Oakland, CA 94602
MedicalResearch.com: What is the background for this study?
Response: Alcoholic liver disease is a major cause of chronic liver disease in the United States and has become the leading indication for liver transplantation in the U.S. However, accurate estimates of the true burden among U.S. adults is not well studies due to challenges in accurately identifying alcoholic liver disease or lack of awareness is screening individuals for alcohol use disorder. Given the gaps in knowledge regarding the epidemiology of alcoholic liver disease in the U.S., our current study attempts to further contribute to the understanding of alcoholic liver disease epidemiology in the U.S
We utilized a U.S. national cross sectional database and focused on the specific subset of alcoholic fatty liver disease, which is the earlier stage of disease along the spectrum of alcoholic liver disease. Focusing on alcoholic fatty liver disease allowed us to more accurately define and capture the prevalence of this disease. Furthermore, given that alcoholic fatty liver disease is early on the overall spectrum of alcoholic liver disease, it is a disease state that early identification provides opportunities to implement therapy and counseling for alcohol abstinence that can prevent further liver damage and disease progression.
MedicalResearch.com: What are the main findings?
Response: The main findings of our study were that while the overall prevalence of alcoholic fatty liver disease among U.S. adults was stable from 2001 to 2016 (from 4.3% to 4.7%), which represents about 11.6 million adults with alcoholic fatty liver, the prevalence of patients with alcoholic fatty liver and progressive damage leading to hepatic fibrosis was rising. For example, from 2001 to 2016, the overall prevalence of patients with alcoholic fatty liver disease and stage 2 or greater fibrosis increased from 0.6% to 1.5%, representing about 3.7 million adults, and the prevalence with stage 3 or greater fibrosis doubled from 0.1% to 0.2%, representing nearly half a million adults.
MedicalResearch.com: What should readers take away from your report?
Response: The main take-away from our study is to highlight the significant burden of alcoholic liver disease in the United States. While we focused on a earlier stage subset of alcoholic fatty liver disease and observed that the overall prevalence remained stable, it is concerning to observe the increasing severity of liver disease among these patients with significantly increasing prevalence of patients with hepatic fibrosis.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Given that our study focused on the subset of patients with alcoholic fatty liver disease and specifically excluded patients with other co-morbid liver diseases, we likely underestimated the true burden of alcoholic liver disease in the U.S. Thus future studies will need to develop methods and datasets that more accurately capture the true burden of alcoholic liver disease using a more comprehensive methodological approach.
MedicalResearch.com: Is there anything else you would like to add?
Response: These data additionally emphasize the importance of raising awareness of the dangers of unhealthy alcohol consumption and the need for more effective implementation of early intervention and prevention efforts before patients develop alcohol-related liver disease.
Disclosures: Research grants, consultant, advisory board, speaker’s bureau – Gilead Sciences
Research grant: Abbvie
I am supported by an American Association for the Study of Liver Diseases (AASLD) Foundation Clinical and Translational Research Award in Liver Diseases
Wong T, Dang K, Ladhani S, Singal AK, Wong RJ. Prevalence of Alcoholic Fatty Liver Disease Among Adults in the United States, 2001-2016. JAMA. 2019;321(17):1723–1725. doi:10.1001/jama.2019.2276
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