ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 131
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Prevalence of non-alcoholic fatty liver disease and
advanced fibrosis risk identification in primary care clinics
Miss Jing Ya Chang1, Kuan-Yu Lai1, Hsian-Han Kao1, Ching-Chun Lin1, Chun-Yi Wang3,
Tsung Po Chen1,2, Dr Wen-Yuan Lin1,2
Department of Family Medicine, China Medical University Hospital, 2Department of Family Medicine,
School of Medicine, China Medical University, 3Da-An Public Health Center, Taichung
1
Background
Non-alcoholic fatty liver disease (NAFLD) is caused by fat accumulation in hepatocytes in the absence
of excessive alcohol intake or other secondary causes. The disease may progress to fibrosis, cirrhosis
and hepatocellular carcinoma (HCC). After the campaign of HCV eradication, NAFLD will become the
most common cause of HCC. Effective screening tools or pathways for the identification of high-risk
groups should be developed.
Methods
In all, 138 subjects were recruited from the outpatient clinic of family medicine between 2021
and 2022. Anthropometric measurements, lifestyle questionnaires, laboratory tests, abdominal
ultrasonography and transient elastography were collected. Fibrosis-4 was used as non-invasive test
for advanced fibrosis. The prevalence of NAFLD was analysed among participants with or without
type 2 diabetes and obesity (defined as a body mass index ≥27 kg/m2). Two clinical care pathways
from the European Association for the Study of Liver (EASL) in 2016 and American Gastroenterological
Association (AGA) in 2021 were used for identifying high-risk patients with advanced fibrosis.
Results
The mean patient age was 54.2 ± 15.7 years, with 32.6% older than or equal to 65 years of age. The
cases were divided into a diabetic group (52.2%), obese group (29.7%) and control group (18.1%). The
prevalence of NAFLD among the diabetic, obese, and control groups was 75.0%, 87.8%, and 28%,
respectively. When applying the AGA clinical care pathway, 4.3% of participants would be referred
to hepatologist clinics, compared with a 26.8% referral rate when applying the EASL clinical care
pathway.
Conclusion
In this study, the prevalence of NAFLD was 75.0% in the diabetic group and 87.8% in the obese group,
which was significantly higher than NAFLD prevalence in the control group (28%). Different clinical
care pathways demonstrate significantly different referral rates. This study looks forward to raising the
concern of patients with a high risk of NAFLD.
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