Clinical–Liver, Pancreas, and Biliary TractImpact of Fatty Liver Disease on Health Care Utilization and Costs in a General Population: A 5-Year Observation
Section snippets
General Population Sample
Data from SHIP were used.13 The target population was adult (20–79 years of age) German residents of West Pomerania in northeastern Germany. The study area comprised 3 cities and 29 communities with a total population of 212,157 residents. A multistage sampling scheme was adopted from the World Health Organization’s (WHO) MONICA Project, Germany.14 From the total population, a sample of 7008 subjects was drawn from the residents’ registration offices in 1996. The net sample (after exclusion of
Baseline Characteristics of Study Participants by FLD Status
There were 1264 (29.9%) individuals with hyperechogenic pattern of the liver, and 667 (15.8%) had increased serum ALT levels. Among those without hyperechogenic pattern of the liver, 2520 (59.7%) had no increased serum ALT levels, and 440 (10.4%) had increased serum ALT levels (Table 1).
Individuals with liver hyperechogenity or increased serum ALT levels had higher plasma levels of fibrinogen; MCV values; and serum levels of AST, ALT, and GGT than individuals with no liver disorders. Subjects
Discussion
In this study, we examined the relation of FLD and health care utilization and costs based on a prospective cohort of 4224 adults aged 20 to 79 years at baseline and over 5 years. To the best of our knowledge, this is the first study looking at health care use and costs associated with FLD. We found that liver hyperechogenity in combination with elevated serum ALT levels predicts future higher health care costs and utilization, after controlling for socioeconomic, behavioral variables, and
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Conflicts of interest: No conflicts of interest are declared.
Supported by the Community Medicine Research net (CMR) of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grant ZZ9603), the Ministry of Cultural Affairs, and the Social Ministry of the Federal State of Mecklenburg-West Pomerania.
The CMR encompasses several research projects that are sharing data of the population-based Study of Health in Pomerania (SHIP; http://ship.community-medicine.de).