Original article—liver, pancreas, and biliary tractChanges in the Prevalence of the Most Common Causes of Chronic Liver Diseases in the United States From 1988 to 2008
Section snippets
Study Population
This study was based on data obtained from the National Health and Nutrition Examination Survey (NHANES), a nationwide survey representing the health and nutritional status of the noninstitutionalized civilian US population. The data were collected by the US National Center for Health Statistics of the Centers for Disease Control and Prevention via household interviews, physical examinations, and laboratory data including blood and urine samples collected in designated examination centers. We
Study Population
This study included a cohort of 39,500 adults from 3 NHANES cycles (N = 15,855 from NHANES 1988–1994, 13,970 from NHANES 1999–2004, and 9670 from 2005–2008) with complete clinical, demographic, and laboratory data (Table 1).
Prevalence of Chronic Liver Diseases and Subtypes
Our analyses suggest that prevalence rates for CLDs are steadily increasing: 11.78% ± 0.48% (1988–1994), 15.66% ± 0.41% (1999–2004), and 14.78% ± 0.58% (2005–2008) (P < .0001). The rates for different types of CLDs during the same time period indicate that the prevalence of
Discussion
This is a population-based study assessing changes in the prevalence of common causes of CLD in the United States over the past 2 decades (Figure 1). A major finding of this study is that the prevalence of CLD, in general, is steadily increasing. This increase in the prevalence of CLD suggests that liver disease will remain among one of the major causes of mortality and morbidity in the United States and will be responsible for substantial medical resource use. This issue becomes especially
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This article has an accompanying continuing medical education activity on page e60. Learning Objectives—At the end of this activity, the learner will recognize the increasing prevalence of nonalcoholic fatty liver disease in the United States, understand the implications of the rising obesity epidemic on the prevalence of nonalcoholic fatty liver disease, and learn that the rates of other important causes of chronic liver disease such as viral hepatitis and alcoholic liver disease have remained stable.
Conflicts of interest The authors disclose no conflicts.
Funding This study was supported in part by the Liver Disease Outcomes Fund of the Center for Liver Diseases at Inova Fairfax Hospital, Inova Health System (Falls Church, VA).
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