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- Title
Screening and Referral Practices for Nonalcoholic Fatty Liver Disease by Race and Ethnicity in a Primary Care Clinic.
- Authors
Patil, Rashmi; Nagaraj, Pooja Kutagol; Kuo, Hui-Chien; Noel, Gillian
- Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common pediatric liver disease in the developed world, with primary care providers caring for many at-risk children. The prevalence of NAFLD varies widely by race and ethnicity. Objective: To explore racial differences in screening and referral patterns for NAFLD among a high-risk pediatric population. Methods: This retrospective cohort study studied primary care patients at Children's of Alabama aged 5–17 years with BMI ≥ 85th percentile from 2008 to 2018. The main outcomes of interest were screening for NAFLD with alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and referral to Hepatology, Endocrinology, or Weight Management clinics. Results: Of 666 children with BMI ≥ 85th percentile, 65% were screened at least once for NAFLD during the designated study period. Liver enzyme screening was performed in 54% of Hispanic Whites, 50% of non-Hispanic Whites, and 74% of African Americans (p-value < 0.001). African American patients had the lowest rate of abnormal liver enzymes (defined as ALT and/or AST > 1 × upper limit of normal). Among all patients with abnormal liver enzymes, 87% of non-Hispanic Whites, 92% of Hispanic Whites, and 17% of African Americans were referred (p-value < 0.0001). Conclusions: Significant differences exist in NAFLD screening and referral practices by race/ethnicity. African Americans were far less likely to be referred for abnormal screening labs than their counterparts of other races. Awareness of these differences may allow for more intentional efforts to standardize practices, ensuring all patients receive care according to established guidelines.
- Subjects
ALABAMA; OBESITY; STATISTICS; KRUSKAL-Wallis Test; CONFIDENCE intervals; HISPANIC Americans; ANTHROPOMETRY; ONE-way analysis of variance; NON-alcoholic fatty liver disease; MEDICAL screening; RACE; RETROSPECTIVE studies; COGNITION; CIRRHOSIS of the liver; PRIMARY health care; MEDICAL referrals; DISEASE prevalence; DESCRIPTIVE statistics; CHI-squared test; BODY mass index; DEMOGRAPHY; DATA analysis; LONGITUDINAL method; PROBABILITY theory; AFRICAN Americans; ALANINE aminotransferase; COMORBIDITY; FAMILY history (Medicine)
- Publication
Journal of Racial & Ethnic Health Disparities, 2023, Vol 10, Issue 3, p1392
- ISSN
2197-3792
- Publication type
Article
- DOI
10.1007/s40615-022-01324-4