Epidemiology of Ultrasound-Defined NAFLD in the General U.S. Population

美国普通人群中超声诊断的 NAFLD 的流行病学

基本信息

批准号：
7943018
负责人：
JEANNE M CLARK
金额：
$ 40.29万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-30 至 2012-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7943018
关键词：
Accounting Address Adult Affect Age Biological Markers Cardiovascular Diseases Cardiovascular system Cessation of life Characteristics Chronic Chronic Disease Cirrhosis Cohort Studies Country Cross-Sectional Studies Data Data Analyses Development Diabetes Mellitus Diagnostic Procedure Diet Disease Epidemic Epidemiology Ethnic Origin Exercise Fatty Liver Funding Future Gallbladder Genetic Goals Hour Image Insulin Resistance Interdisciplinary Study Interview Investigation Laboratories Life Style Link Liver Liver Fibrosis Liver diseases Measures National Health and Nutrition Examination Survey Non-Insulin-Dependent Diabetes Mellitus Obesity Participant Pathogenesis Physicians Pilot Projects Population Prevalence Protocols documentation Public Health Publishing Race Reading Research Personnel Risk Risk Estimate Risk Factors Role Sampling Smoking Staging Subgroup Surveys Time Training Ultrasonography United States cardiovascular disorder risk experience genetic risk factor genetic variant genome wide association study lifestyle factors liver imaging mortality non-alcoholic fatty liver nonalcoholic steatohepatitis novel nutrition prevent public health relevance sex

项目摘要

DESCRIPTION (provided by applicant): With the global epidemic of obesity and diabetes, the burden of other chronic diseases is increasing. Nonalcoholic fatty liver disease (NAFLD) is one such disease that now has potentially enormous public health consequences. NAFLD is a leading cause of chronic liver disease and cirrhosis, affecting up to 30% of people in other countries. However, in the United States (U.S.) there are no reliable estimates of NAFLD prevalence. Depending on the diagnostic method, estimates range from 5 to 33%. The major risk factors for NAFLD include type 2 diabetes, obesity and insulin resistance. Yet the role of demographic, genetic and lifestyle factors in the development of NAFLD has not been studied in a nationally representative sample of the U.S. population. Finally, while NAFLD is thought to increase the risk of liver-related mortality, recent data suggest that NAFLD may also increase cardiovascular disease risk and mortality. Our overarching goals are to (1) better define the epidemiology of NAFLD in the general U.S. population, including describing the cross-sectional demographic, lifestyle and genetic correlates of NAFLD, and (2) assess whether NAFLD increases the risk of all-cause and cardiovascular mortality over time. To achieve these goals, the investigators propose to use existing data and images from The Third National Health And Nutrition Examination Survey (NHANES III) to construct the first nationally representative cohort study of NAFLD and related mortality. Specifically, NHANES III included standardized gallbladder ultrasounds which can be reread to detect hepatic steatosis and the findings linked to all NHANES III data. The proposed study has the following 3 specific aims: (1) Read the available NHANES III ultrasounds (N=14,294) to measure hepatic steatosis and link the results to other existing NHANES data; (2) Describe the epidemiology of NAFLD and its association with demographic characteristics, lifestyle-related factors and available genetic variants; and (3) Examine the independent contribution of NAFLD to the risk of subsequent all-cause and cardiovascular mortality after taking into account well established risk factors. This study will provide a population-wide estimate of the prevalence of NAFLD in the U.S., including data in key age, sex, and race subgroups as well as identify potentially novel lifestyle-related and genetic risk factors. Importantly, it will also estimate the risk of death among people with NAFLD. Finally, all the ultrasound data will be made publicly available, setting the stage for future investigation. PUBLIC HEALTH RELEVANCE: This study will help identify important risk factors for nonalcoholic fatty liver disease (NAFLD) in the general U.S. population and determine whether it increases the overall risk of death and death from cardiovascular disease. Since NAFLD is now a leading cause of chronic liver disease, this information is important to help find ways to prevent it, as well as track its effect on the population over time.

描述（由申请人提供）：随着肥胖和糖尿病的全球流行，其他慢性疾病的负担正在增加。非酒精性脂肪肝疾病（NAFLD）就是一种这样的疾病，现在可能会带来巨大的公共卫生后果。 NAFLD是慢性肝病和肝硬化的主要原因，影响了其他国家多达30％的人。但是，在美国（美国）没有可靠的NAFLD患病率估计。根据诊断方法，估计值在5％至33％之间。 NAFLD的主要危险因素包括2型糖尿病，肥胖和胰岛素抵抗。然而，在美国人口的全国代表性样本中，人口，遗传和生活方式因素在NAFLD发展中的作用尚未研究。最后，尽管人们认为NAFLD会增加与肝脏相关死亡率的风险，但最近的数据表明NAFLD也可能增加心血管疾病的风险和死亡率。我们的总体目标是（1）更好地定义NAFLD在美国普通人群中的流行病学，包括描述NAFLD的横截面人口统计，生活方式和遗传相关性，以及（2）NAFLD评估是否会增加所有因素和心血管死亡的风险。为了实现这些目标，调查人员建议使用第三个国家卫生和营养检查调查（NHANES III）的现有数据和图像来构建NAFLD和相关死亡率的首次全国代表性队列研究。具体而言，NHANES III包括标准化的胆囊超声检查，可以重新读取以检测肝脂肪变性以及与所有NHANES III数据相关的发现。拟议的研究具有以下3个具体目的：（1）阅读可用的NHANES III超声（n = 14,294），以测量肝脂肪变性，并将结果与其他现有的NHANES数据联系起来；（2）描述NAFLD的流行病学及其与人口统计学特征，与生活方式相关的因素和可用遗传变异的关联；（3）在考虑到良好的危险因素后，检查NAFLD对随后的全原因和心血管死亡率的风险的独立贡献。这项研究将对美国NAFLD患病率的人口范围估计，包括关键年龄，性别和种族亚组中的数据，并确定潜在的新型与生活方式有关的与生活方式有关和遗传危险因素。重要的是，它还将估计NAFLD患者死亡的风险。最后，所有超声数据都将公开可用，为将来的研究奠定了基础。公共卫生相关性：这项研究将有助于确定美国普通人群中非酒精性脂肪肝病（NAFLD）的重要危险因素，并确定它是否增加了心血管疾病死亡和死亡的总体风险。由于NAFLD现在是慢性肝病的主要原因，因此该信息对于帮助寻找方法以及随着时间的推移对人群的影响很重要。