Results of the observational cross-over PRELID 2 study (2015–2016). Part 2. Risk factors of non-alcoholic fatty liver disease and treatment options in patients seeking general practitioners’ and gastroenterologists’ help in Ukraine
Background. The purpose was to evaluate the presence of risk factors and underlying disorders in patients with confirmed and unconfirmed diagnosis of non-alcoholic fatty liver disease (NAFLD); the benefits of practicing physicians regarding pharmacological and non-pharmacological treatments of NAFLD under conditions of real clinical practice. Materials and methods. The study included 5,000 patients (an average of 50 patients from 100 research centers), 2,450 women (49.00 %) and 2,550 men (51.00 %), middle age — (52.83 ± 12.33) years. To conduct research in Ukraine, 100 gastroenterological departments were selected. The list of research centers included departments with qualified staff, provided with proper materials and technical equipment, with the obligatory presence of the local Ethics Committee. The data used in the study were obtained during one regular patient’s visit to the center included in the study. During the visit, the basic data of the patient, data of instrumental examination (ultrasound of the liver), results of laboratory tests, data on the application of treatment methods (pharmacological and non-pharmacological) were recorded. Diagnosis of NAFLD was established or excluded on the basis of laboratory and instrumental data entered into medical cards. Results. Overall, the risk factors for NAFLD were detected in 4,650 (93.00 %) patients. Most often, overweight (91.90 %), hypercholesterolemia (61.44 %), and hyperlipidemia (41.23 %) were found. The frequency of virtually all investigated risk factors (with the exception of hypercholesterolemia) is significantly higher (p < 0.05) in the group of patients with a confirmed diagnosis of NAFLD than in those with an unconfirmed diagnosis of NAFLD. Non-pharmacological and pharmacological treatment methods were used in most patients (90.44 and 93.82 %, respectively). Most non-pharmacological and pharmacological treatments were significantly more frequently used in patients with a confirmed diagnosis of NAFLD (p < 0.05). Conclusions. According to the results of the study, the most important risk factors of NAFLD were identified. The frequency of virtually all investigated risk factors (with the exception of hypercholesterolemia) is significantly higher (p < 0.05) in the group of patients with confirmed diagnosis of NAFLD than in persons with an unconfirmed diagnosis of NAFLD. The research also allowed evaluating the pharmacological and non-pharmacological methods that are most often used in the treatment of patients with NAFLD in Ukraine.
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