Are there ethnicity-based differences in the evaluation of individuals with abnormal liver biochemistries?>

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Abstract

Background/Aims: Recent studies suggested NAFLD is less infrequent in African Americans (AA) than in Caucasians but it is unclear if this difference is biological or due to under-recognition/under-referral. This study examined if there is an ethnicity-based difference in obtaining liver biochemistries or evaluating abnormal liver biochemistries by primary care physicians. Methods: This study consisted of 45,016 AA and 49,660 Caucasians seen at our primary care clinics over a 3-year period. From these two groups, we identified patients with elevated aminotransferases (AA: 3676, Caucasians: 4644) and elevated bilirubin (AA: 1295, Caucasians: 1199) based on predefined criteria. Subsequently, we assessed the proportion of patients in each group who had liver-specific evaluation (viral serologies, abdominal imaging or GI clinic visit). Results: Among patients with elevated aminotransferases, compared to Caucasians, AA did not have lower testing for viral hepatitis (26% vs. 25%), imaging (16% vs. 13%) or GI clinic visits (17% vs. 17%). Similarly, we did not observe clinically significant difference in the evaluation of elevated bilirubin between AA and Caucasians (viral serologies: 22% vs. 22%; imaging: 25% vs. 27%; GI clinic: 15% vs. 21%). Conclusions: Under-recognition and under-referral are not likely to explain the reported ethnic differences in the prevalence of NAFLD.

Original languageEnglish
Pages (from-to)123-127
Number of pages5
JournalJournal of Hepatology
Volume47
Issue number1
DOIs
StatePublished - Jul 2007

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African Americans
Biochemistry
Liver
Serology
Ambulatory Care
Transaminases
Bilirubin
Referral and Consultation
Primary Care Physicians
Hepatitis
Primary Health Care
Non-alcoholic Fatty Liver Disease

Keywords

  • Aminotransferase
  • Charlson index
  • Fatty liver

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Are there ethnicity-based differences in the evaluation of individuals with abnormal liver biochemistries?> / Chalasani, Naga; Saha, Chandan; Teal, Evgenia.

In: Journal of Hepatology, Vol. 47, No. 1, 07.2007, p. 123-127.

Research output: Contribution to journalArticle

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abstract = "Background/Aims: Recent studies suggested NAFLD is less infrequent in African Americans (AA) than in Caucasians but it is unclear if this difference is biological or due to under-recognition/under-referral. This study examined if there is an ethnicity-based difference in obtaining liver biochemistries or evaluating abnormal liver biochemistries by primary care physicians. Methods: This study consisted of 45,016 AA and 49,660 Caucasians seen at our primary care clinics over a 3-year period. From these two groups, we identified patients with elevated aminotransferases (AA: 3676, Caucasians: 4644) and elevated bilirubin (AA: 1295, Caucasians: 1199) based on predefined criteria. Subsequently, we assessed the proportion of patients in each group who had liver-specific evaluation (viral serologies, abdominal imaging or GI clinic visit). Results: Among patients with elevated aminotransferases, compared to Caucasians, AA did not have lower testing for viral hepatitis (26{\%} vs. 25{\%}), imaging (16{\%} vs. 13{\%}) or GI clinic visits (17{\%} vs. 17{\%}). Similarly, we did not observe clinically significant difference in the evaluation of elevated bilirubin between AA and Caucasians (viral serologies: 22{\%} vs. 22{\%}; imaging: 25{\%} vs. 27{\%}; GI clinic: 15{\%} vs. 21{\%}). Conclusions: Under-recognition and under-referral are not likely to explain the reported ethnic differences in the prevalence of NAFLD.",
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