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Occult liver disease burden: Analysis from a large general practitioners' database.

Andrea Martini1, Elena Ceranto1, Angelo Gatta1

  • 1Internal Medicine and Hepatology, Regional Referral Center for Liver Disease, Department of Medicine, University of Padua, Italy.

United European Gastroenterology Journal
|November 23, 2017
PubMed
Summary

Many individuals have undiagnosed chronic liver disease and cirrhosis. Surrogate biochemical indicators like high transaminases and thrombocytopenia can help identify these patients in primary care settings.

Keywords:
Chronic liver diseaseliver cirrhosisliver disease epidemiologymetabolic syndromesurrogate indicators

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Area of Science:

  • Hepatology
  • Primary Care Medicine
  • Epidemiology

Background:

  • Cirrhosis is the advanced stage of chronic liver disease, associated with significant mortality and morbidity.
  • Assessing liver disease prevalence is challenging due to its often asymptomatic nature until late stages.

Purpose of the Study:

  • To determine the prevalence of unrecognized chronic liver disease and cirrhosis.
  • To utilize surrogate indicators from family physician records for disease assessment.

Main Methods:

  • Analysis of 139,104 medical records from 99 family physicians in the Veneto region.
  • Identified occult chronic liver disease using persistently high transaminases.
  • Identified occult cirrhosis using thrombocytopenia (excluding hematological malignancies).

Main Results:

  • Elevated transaminases were observed in 32.7% of subjects; only one-third had a prior liver disease diagnosis.
  • Diagnosed cirrhosis was 0.3%, while thrombocytopenia (indicating occult cirrhosis) was found in 1.3% of the remaining population.
  • Patients with overt and occult cirrhosis exhibited a worse metabolic profile, including higher rates of hypertension, obesity, and diabetes.

Conclusions:

  • A substantial number of patients with chronic liver disease remain undiagnosed.
  • Biochemical markers serve as valuable tools for early disease recognition in primary care.