Nationwide Trends in Liver Stiffness Measurement in Japan: A Real-World Evidence of NILDA Using the National Database...

Liver stiffness measurement is a noninvasive liver disease assessment (NILDA) for hepatic fibrosis and is covered by health insurance in Japan. This study aimed to examine nationwide trends in liver stiffness measurement in Japan by analyzing data from the National Database of Health Insurance Claims (NDB).

We analyzed NDB open data from 2016 to 2020. In the NDB, liver stiffness measurement (Medical Fee Schedule Code: D215-2) includes both imaging techniques (transient elastography) and biochemical examinations (mac-2 binding protein glycosylation isomer). The claim number was counted across all 47 Prefectures in Japan.

The annual number of liver stiffness measurements all over Japan was 76,183 in 2016. The number increased to 124,584 in 2020, representing a 1.64-fold increase during this period. The annual number of liver stiffness measurements adjusted by population size (1000 population) was 0.60 in 2016. The numbers were 0.64, 0.53, 0.89, and 0.99 in 2017, 2018, 2019, and 2020, respectively. There was a 1.67-fold increase during the period. We carried out statistical analysis using Poisson regression, which confirmed that the observed increases in liver stiffness measurement uptake were statistically significant (p < 0.0001). In almost all Prefectures, the population-adjusted number of liver stiffness measurements showed an increasing trend. Notably, Saga Prefecture had the highest prevalence of liver stiffness measurements (4.10) during the period. This was followed by Kagawa (3.19), Miyazaki (2.70), and Wakayama (2.44) Prefectures.

The number of liver stiffness measurements has increased from 2016 to 2020 throughout Japan. Liver stiffness has been increasingly measured nationwide and is expected to become a valuable NILDA for identifying at-risk patients and evaluating treatment efficacy in steatotic liver disease.