Clinical characteristics in patients with non-alcoholic steatohepatitis in Japan: a case–control study using a 5-year large-scale claims database
Objectives To examine the clinical characteristics of patients with non-alcoholic steatohepatitis (NASH) and associated comorbidities.Design A case–control study using the national health insurance and the long-term elderly health insurance claims database.Setting Eligible patients diagnosed with NA...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/8/e074851.full |
| _version_ | 1797739177464299520 |
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| author | Kei Tokutsu Shinya Matsuda Kaoru Ito Shigeki Kawazoe Sota Minami Kenji Fujimoto Keiji Muramatsu |
| author_facet | Kei Tokutsu Shinya Matsuda Kaoru Ito Shigeki Kawazoe Sota Minami Kenji Fujimoto Keiji Muramatsu |
| author_sort | Kei Tokutsu |
| collection | DOAJ |
| description | Objectives To examine the clinical characteristics of patients with non-alcoholic steatohepatitis (NASH) and associated comorbidities.Design A case–control study using the national health insurance and the long-term elderly health insurance claims database.Setting Eligible patients diagnosed with NASH (ICD-10 K-75.8, other inflammatory liver disease or K-76.0, other fatty liver) between April 2015 and March 2020 were included.Participants Patients who met the diagnostic definitions for NASH (n=545) were matched with non-NASH controls (n=185 264) and randomly selected according to sex, birth year and residential area.Interventions No interventions were made.Primary and secondary outcome measures ORs were estimated for the relationship between patient background, such as age and sex, body mass index (BMI), NASH-related comorbidities and lifestyle-related diseases.Results In total, 545 patients with NASH (38.3% men) and 185 264 non-NASH controls (43.2% men) were identified, with median ages of 68 (IQR 63.0–75.0) and 65 (IQR 44.0–74.0) years, respectively. BMI was significantly higher in patients with NASH than in controls (25.8 kg/m2 vs 22.9 kg/m2, p<0.001). The proportions of women, patients with hypertension, patients with dyslipidaemia and patients with type 2 diabetes were higher in the NASH group. In addition, NASH was associated with an increased risk of hepatic cirrhosis (OR 28.81 (95% CI 21.79 to 38.08)), followed by liver cancer (OR 18.38 (95% CI 12.56 to 26.89)). There was no significant association between NASH and risk for depression (OR 1.11 (95% CI 0.87 to 1.41)), insomnia (OR 1.12 (95% CI 0.94 to 1.34)) or chronic kidney diseases (OR 0.81 (95% CI 0.58 to 1.12)).Conclusions In the daily medical care of patients, it is necessary to consider sex and age differences and to pay close attention to the risk of liver cancer, as well as other lifestyle-related comorbidities associated with NASH. |
| first_indexed | 2024-03-12T13:54:34Z |
| format | Article |
| id | doaj.art-11e660d91ee443c4acd511d0e3f3b70c |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T13:54:34Z |
| publishDate | 2023-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-11e660d91ee443c4acd511d0e3f3b70c2023-08-22T17:30:07ZengBMJ Publishing GroupBMJ Open2044-60552023-08-0113810.1136/bmjopen-2023-074851Clinical characteristics in patients with non-alcoholic steatohepatitis in Japan: a case–control study using a 5-year large-scale claims databaseKei Tokutsu0Shinya Matsuda1Kaoru Ito2Shigeki Kawazoe3Sota Minami4Kenji Fujimoto5Keiji Muramatsu6Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health Japan, Kitakyushu, JapanDepartment of Preventive Medicine and Community Health, University of Occupational and Environmental Health Japan, Kitakyushu, JapanDepartment of Preventive Medicine and Community Health, University of Occupational and Environmental Health Japan, Kitakyushu, JapanDepartment of Preventive Medicine and Community Health, University of Occupational and Environmental Health Japan, Kitakyushu, JapanThird Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, JapanOccupational Health Data Science Center, University of Occupational and Environmental Health Japan, Kitakyushu, JapanDepartment of Preventive Medicine and Community Health, University of Occupational and Environmental Health Japan, Kitakyushu, JapanObjectives To examine the clinical characteristics of patients with non-alcoholic steatohepatitis (NASH) and associated comorbidities.Design A case–control study using the national health insurance and the long-term elderly health insurance claims database.Setting Eligible patients diagnosed with NASH (ICD-10 K-75.8, other inflammatory liver disease or K-76.0, other fatty liver) between April 2015 and March 2020 were included.Participants Patients who met the diagnostic definitions for NASH (n=545) were matched with non-NASH controls (n=185 264) and randomly selected according to sex, birth year and residential area.Interventions No interventions were made.Primary and secondary outcome measures ORs were estimated for the relationship between patient background, such as age and sex, body mass index (BMI), NASH-related comorbidities and lifestyle-related diseases.Results In total, 545 patients with NASH (38.3% men) and 185 264 non-NASH controls (43.2% men) were identified, with median ages of 68 (IQR 63.0–75.0) and 65 (IQR 44.0–74.0) years, respectively. BMI was significantly higher in patients with NASH than in controls (25.8 kg/m2 vs 22.9 kg/m2, p<0.001). The proportions of women, patients with hypertension, patients with dyslipidaemia and patients with type 2 diabetes were higher in the NASH group. In addition, NASH was associated with an increased risk of hepatic cirrhosis (OR 28.81 (95% CI 21.79 to 38.08)), followed by liver cancer (OR 18.38 (95% CI 12.56 to 26.89)). There was no significant association between NASH and risk for depression (OR 1.11 (95% CI 0.87 to 1.41)), insomnia (OR 1.12 (95% CI 0.94 to 1.34)) or chronic kidney diseases (OR 0.81 (95% CI 0.58 to 1.12)).Conclusions In the daily medical care of patients, it is necessary to consider sex and age differences and to pay close attention to the risk of liver cancer, as well as other lifestyle-related comorbidities associated with NASH.https://bmjopen.bmj.com/content/13/8/e074851.full |
| spellingShingle | Kei Tokutsu Shinya Matsuda Kaoru Ito Shigeki Kawazoe Sota Minami Kenji Fujimoto Keiji Muramatsu Clinical characteristics in patients with non-alcoholic steatohepatitis in Japan: a case–control study using a 5-year large-scale claims database BMJ Open |
| title | Clinical characteristics in patients with non-alcoholic steatohepatitis in Japan: a case–control study using a 5-year large-scale claims database |
| title_full | Clinical characteristics in patients with non-alcoholic steatohepatitis in Japan: a case–control study using a 5-year large-scale claims database |
| title_fullStr | Clinical characteristics in patients with non-alcoholic steatohepatitis in Japan: a case–control study using a 5-year large-scale claims database |
| title_full_unstemmed | Clinical characteristics in patients with non-alcoholic steatohepatitis in Japan: a case–control study using a 5-year large-scale claims database |
| title_short | Clinical characteristics in patients with non-alcoholic steatohepatitis in Japan: a case–control study using a 5-year large-scale claims database |
| title_sort | clinical characteristics in patients with non alcoholic steatohepatitis in japan a case control study using a 5 year large scale claims database |
| url | https://bmjopen.bmj.com/content/13/8/e074851.full |
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