PDF(Pubmed)
Abstract：
UNASSIGNED: The prevalence and aetiology of liver fibrosis vary over time and impact racial/ethnic groups unevenly. This study measured time trends and identified factors associated with advanced liver fibrosis in the United States.
UNASSIGNED: Standardised methods were used to analyse data on 47,422 participants (≥20 years old) in the National Health and Nutrition Examination Survey (1999-2018). Advanced liver fibrosis was defined as Fibrosis-4 ≥2.67 and/or Forns index ≥6.9 and elevated alanine aminotransferase.
UNASSIGNED: The estimated number of people with advanced liver fibrosis increased from 1.3 million (95% CI 0.8-1.9) to 3.5 million (95% CI 2.8-4.2), a nearly threefold increase. Prevalence was higher in non-Hispanic Black and Mexican American persons than in non-Hispanic White persons. In multivariable logistic regression analysis, cadmium was an independent risk factor in all racial/ethnic groups. Smoking and current excessive alcohol use were risk factors in most. Importantly, compared with non-Hispanic White persons, non-Hispanic Black persons had a distinctive set of risk factors that included poverty (odds ratio [OR] 2.09; 95% CI 1.44-3.03) and susceptibility to lead exposure (OR 3.25; 95% CI 1.95-5.43) but did not include diabetes (OR 0.88; 95% CI 0.61-1.27; p =0.52). Non-Hispanic Black persons were more likely to have high exposure to lead, cadmium, polychlorinated biphenyls, and poverty than non-Hispanic White persons.
UNASSIGNED: The number of people with advanced liver fibrosis has increased, creating a need to expand the liver care workforce. The risk factors for advanced fibrosis vary by race/ethnicity. These differences provide useful information for designing screening programmes. Poverty and toxic exposures were associated with the high prevalence of advanced liver fibrosis in non-Hispanic Black persons and need to be addressed.
UNASSIGNED: Because liver disease often produces few warning signs, simple and inexpensive screening tests that can be performed by non-specialists are needed to allow timely diagnosis and linkage to care. This study shows that non-Hispanic Black persons have a distinctive set of risk factors that need to be taken into account when designing liver disease screening programs. Exposure to exogenous toxins may be especially important risk factors for advanced liver fibrosis in non-Hispanic Black persons.
UNASSIGNED: Standardised methods were used to analyse data on 47,422 participants (≥20 years old) in the National Health and Nutrition Examination Survey (1999-2018). Advanced liver fibrosis was defined as Fibrosis-4 ≥2.67 and/or Forns index ≥6.9 and elevated alanine aminotransferase.
UNASSIGNED: The estimated number of people with advanced liver fibrosis increased from 1.3 million (95% CI 0.8-1.9) to 3.5 million (95% CI 2.8-4.2), a nearly threefold increase. Prevalence was higher in non-Hispanic Black and Mexican American persons than in non-Hispanic White persons. In multivariable logistic regression analysis, cadmium was an independent risk factor in all racial/ethnic groups. Smoking and current excessive alcohol use were risk factors in most. Importantly, compared with non-Hispanic White persons, non-Hispanic Black persons had a distinctive set of risk factors that included poverty (odds ratio [OR] 2.09; 95% CI 1.44-3.03) and susceptibility to lead exposure (OR 3.25; 95% CI 1.95-5.43) but did not include diabetes (OR 0.88; 95% CI 0.61-1.27; p =0.52). Non-Hispanic Black persons were more likely to have high exposure to lead, cadmium, polychlorinated biphenyls, and poverty than non-Hispanic White persons.
UNASSIGNED: The number of people with advanced liver fibrosis has increased, creating a need to expand the liver care workforce. The risk factors for advanced fibrosis vary by race/ethnicity. These differences provide useful information for designing screening programmes. Poverty and toxic exposures were associated with the high prevalence of advanced liver fibrosis in non-Hispanic Black persons and need to be addressed.
UNASSIGNED: Because liver disease often produces few warning signs, simple and inexpensive screening tests that can be performed by non-specialists are needed to allow timely diagnosis and linkage to care. This study shows that non-Hispanic Black persons have a distinctive set of risk factors that need to be taken into account when designing liver disease screening programs. Exposure to exogenous toxins may be especially important risk factors for advanced liver fibrosis in non-Hispanic Black persons.
摘要：
UNASSIGNED：肝纤维化的患病率和病因随着时间的推移而变化，影响种族/民族不均匀。这项研究测量了时间趋势，并确定了与美国晚期肝纤维化相关的因素。
UNASSIGNED：使用标准化方法分析了国家健康和营养检查调查（1999-2018）中47,422名参与者（≥20岁）的数据。晚期肝纤维化定义为纤维化-4≥2.67和/或Forns指数≥6.9和丙氨酸转氨酶升高。
UNASSIGNED：晚期肝纤维化患者的估计人数从130万（95％CI0.8-1.9）增加到350万（95％CI2.8-4.2），几乎增加了三倍。非西班牙裔黑人和墨西哥裔美国人的患病率高于非西班牙裔白人。在多变量逻辑回归分析中，镉是所有种族/族裔群体的独立危险因素。吸烟和目前过度饮酒是大多数人的危险因素。重要的是,与非西班牙裔白人相比，非西班牙裔黑人有一组独特的危险因素,包括贫困(比值比[OR]2.09;95%CI1.44~3.03)和铅暴露易感性(OR3.25;95%CI1.95~5.43),但不包括糖尿病(OR0.88;95%CI0.61~1.27;p=0.52).非西班牙裔黑人更有可能接触铅，镉,多氯联苯,和贫穷比非西班牙裔白人。
UNASSIGNED：晚期肝纤维化患者数量增加，需要扩大肝脏护理队伍。晚期纤维化的危险因素因种族/民族而异。这些差异为设计筛查程序提供了有用的信息。贫困和有毒暴露与非西班牙裔黑人晚期肝纤维化的高患病率相关，需要解决。
未经评估：因为肝病通常很少产生警告信号，需要由非专业人员进行的简单且廉价的筛查测试，以便及时诊断并与护理挂钩。这项研究表明，非西班牙裔黑人有一组独特的风险因素，需要在设计肝病筛查程序时予以考虑。暴露于外源性毒素可能是非西班牙裔黑人晚期肝纤维化的特别重要的危险因素。
UNASSIGNED：使用标准化方法分析了国家健康和营养检查调查（1999-2018）中47,422名参与者（≥20岁）的数据。晚期肝纤维化定义为纤维化-4≥2.67和/或Forns指数≥6.9和丙氨酸转氨酶升高。
UNASSIGNED：晚期肝纤维化患者的估计人数从130万（95％CI0.8-1.9）增加到350万（95％CI2.8-4.2），几乎增加了三倍。非西班牙裔黑人和墨西哥裔美国人的患病率高于非西班牙裔白人。在多变量逻辑回归分析中，镉是所有种族/族裔群体的独立危险因素。吸烟和目前过度饮酒是大多数人的危险因素。重要的是,与非西班牙裔白人相比，非西班牙裔黑人有一组独特的危险因素,包括贫困(比值比[OR]2.09;95%CI1.44~3.03)和铅暴露易感性(OR3.25;95%CI1.95~5.43),但不包括糖尿病(OR0.88;95%CI0.61~1.27;p=0.52).非西班牙裔黑人更有可能接触铅，镉,多氯联苯,和贫穷比非西班牙裔白人。
UNASSIGNED：晚期肝纤维化患者数量增加，需要扩大肝脏护理队伍。晚期纤维化的危险因素因种族/民族而异。这些差异为设计筛查程序提供了有用的信息。贫困和有毒暴露与非西班牙裔黑人晚期肝纤维化的高患病率相关，需要解决。
未经评估：因为肝病通常很少产生警告信号，需要由非专业人员进行的简单且廉价的筛查测试，以便及时诊断并与护理挂钩。这项研究表明，非西班牙裔黑人有一组独特的风险因素，需要在设计肝病筛查程序时予以考虑。暴露于外源性毒素可能是非西班牙裔黑人晚期肝纤维化的特别重要的危险因素。
