The Prevalence of Non-Alcoholic Steatohepatitis among Diabetic Patients Followed by Primary Care and Endocrinology

Joshi, Kalpesh; Thakkar, Jiger M.; Boroń, Alicja; Moore, Alexis; Hepner, Ashley; Deer, James; Rodriguez, M.; Gish, Robert G.; Reynolds, John M.; Manch, Richard; Kohli, Anita

doi:10.1016/s0168-8278(16)00829-1

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“…NASH prevalence in the diabetic population was reported in three publications, ranging from 18% to 87% [24, 41, 42]. Although the NASH prevalence was higher in diabetics alone compared to diabetic bariatric surgery patients, the research focus of the captured publications varied substantially in terms of the geography, with two publications focusing on the USA and one on Finland, and the type of population, such as NASH diabetic and NASH diabetic bariatric surgery patients, therefore making further meaningful comparisons impossible.…”

Section: Resultsmentioning

confidence: 99%

“…Despite this, the specific prevalence of comorbidities in NASH remains unclear with substantial discrepancies in the literature, specifically in sub-populations, such as in obese, morbidly obese, or bariatric surgery patients. For instance, NASH prevalence in a diabetic population was 14.5% in one study, and between 63% and 87% in a different study on the diabetic population [41, 42]. This can be due to several reasons, e.g.…”

Section: Discussionmentioning

confidence: 99%

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A Structured Literature Review of the Epidemiology and Disease Burden of Non-Alcoholic Steatohepatitis (NASH)

et al. 2019

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IntroductionNon-Alcoholic Steatohepatitis (NASH) is a chronic, progressive disease characterized by fatty liver and liver cell injury, advancing to fibrosis, cirrhosis and hepatocellular carcinoma (HCC). Diagnosis involves liver biopsy; however, as a result of its high cost and invasiveness, NASH remains underdiagnosed, and accurate burden of disease (BoD) data are lacking. Our aim was to understand the epidemiological and BoD landscape in NASH and identify knowledge gaps.MethodsThe Ovid search engine was used to conduct a structured review, following quality systematic principles. It included publications that reported on epidemiology, quality of life (QoL) and BoD outcomes in NASH adults. Searches were limited to English language studies published between January 2007 and September 2017. Additional grey literature searches were conducted. A total of 53 references were selected; 38 were peer-reviewed and 15 were grey literature sources.ResultsNASH is estimated to affect 3–5% of the global population, most suffering from several comorbidities. Advancing fibrosis drives clinical outcomes, with approximately 20% of patients developing cirrhosis and/or HCC, the latter being a leading cause of death in NASH. A recent model predicted the 15-year survival of advanced fibrosis patients at F3 and F4 as 51.0% and 28.4%, respectively. The limited data consistently show that NASH patients experience significantly poorer QoL and higher costs compared to non-NASH patients.ConclusionThis first broad-ranging examination of NASH literature revealed a paucity of evidence, with poor-quality, small studies found. The overwhelming impact of NASH and its patient and healthcare burden is evident. Further evidence is needed to improve our understanding of NASH, especially as fibrosis stages advance.FundingGilead Science Inc.Electronic supplementary materialThe online version of this article (10.1007/s12325-019-00960-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%