Screening Patterns of Nonalcoholic Fatty Liver Disease in Children with Obesity in Canadian Primary Care: A Cross-Sectional Study
Background. Nonalcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease, and children with a body mass index (BMI) ≥95th percentile are recommended to be screened for NAFLD by liver enzymes. Objectives. This study aimed to determine the frequency and predictors of scr...
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Published in | Canadian Journal of Gastroenterology and Hepatology Vol. 2022; pp. 8435581 - 9 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Hindawi
2022
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Abstract | Background. Nonalcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease, and children with a body mass index (BMI) ≥95th percentile are recommended to be screened for NAFLD by liver enzymes. Objectives. This study aimed to determine the frequency and predictors of screening for NAFLD among children with obesity in Canada and to evaluate a sample of children with suspected NAFLD. Methods. This cross-sectional study used data from the Canadian Primary Care Sentinel Surveillance Network, a repository of electronic medical record data from Canadian primary care practices. Results. Of n = 110,827 children aged 9–18 years, 13.9% (n = 9,888) had a BMI ≥95th percentile. Only 8.7% (n = 859) of these patients were screened for NAFLD in the last year, and 23.6% (n = 2336) were ever screened. Using logistic regression, screening in the last year was associated with demographic and clinical characteristics, including previous liver enzyme assessment, prior antidiabetic prescription, and prior anxiolytic prescription. Among children with suspected NAFLD (n = 1,046), 34.7% had a BMI ≥99th percentile and approximately 8% were at increased risk of significant liver disease. Conclusion. The study revealed low screening rates for NAFLD in Canadian primary care and highlighted the important role of primary care providers in identifying and managing pediatric NAFLD. |
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AbstractList | Background. Nonalcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease, and children with a body mass index (BMI) ≥95th percentile are recommended to be screened for NAFLD by liver enzymes. Objectives. This study aimed to determine the frequency and predictors of screening for NAFLD among children with obesity in Canada and to evaluate a sample of children with suspected NAFLD. Methods. This cross-sectional study used data from the Canadian Primary Care Sentinel Surveillance Network, a repository of electronic medical record data from Canadian primary care practices. Results. Of n = 110,827 children aged 9–18 years, 13.9% (n = 9,888) had a BMI ≥95th percentile. Only 8.7% (n = 859) of these patients were screened for NAFLD in the last year, and 23.6% (n = 2336) were ever screened. Using logistic regression, screening in the last year was associated with demographic and clinical characteristics, including previous liver enzyme assessment, prior antidiabetic prescription, and prior anxiolytic prescription. Among children with suspected NAFLD (n = 1,046), 34.7% had a BMI ≥99th percentile and approximately 8% were at increased risk of significant liver disease. Conclusion. The study revealed low screening rates for NAFLD in Canadian primary care and highlighted the important role of primary care providers in identifying and managing pediatric NAFLD. Nonalcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease, and children with a body mass index (BMI) ≥95th percentile are recommended to be screened for NAFLD by liver enzymes. This study aimed to determine the frequency and predictors of screening for NAFLD among children with obesity in Canada and to evaluate a sample of children with suspected NAFLD. This cross-sectional study used data from the Canadian Primary Care Sentinel Surveillance Network, a repository of electronic medical record data from Canadian primary care practices. Of = 110,827 children aged 9-18 years, 13.9% ( = 9,888) had a BMI ≥95 percentile. Only 8.7% ( = 859) of these patients were screened for NAFLD in the last year, and 23.6% ( = 2336) were ever screened. Using logistic regression, screening in the last year was associated with demographic and clinical characteristics, including previous liver enzyme assessment, prior antidiabetic prescription, and prior anxiolytic prescription. Among children with suspected NAFLD ( = 1,046), 34.7% had a BMI ≥99 percentile and approximately 8% were at increased risk of significant liver disease. The study revealed low screening rates for NAFLD in Canadian primary care and highlighted the important role of primary care providers in identifying and managing pediatric NAFLD. |
Author | Kehar, Mohit Queenan, John Theal, Rebecca Flemming, Jennifer Morkem, Rachael Barber, David |
AuthorAffiliation | 2 Departments of Medicine and Public Health Sciences, Queen's University, Kingston, Ontario, Canada 1 Department of Family Medicine, Queen's University, Kingston, Ontario, Canada 3 Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada |
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Copyright | Copyright © 2022 Rachael Morkem et al. Copyright © 2022 Rachael Morkem et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0 Copyright © 2022 Rachael Morkem et al. 2022 |
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References | 22 23 24 25 26 S. Canada (8) 2020 27 28 M. Kehar (42) 2021; 74 30 31 10 32 11 33 12 34 13 35 14 36 15 37 16 38 17 39 18 19 1 2 3 D. C. C. P. G. E. Committee (29) 2018; 42 4 5 6 7 9 40 41 V. C. Menec (20) 2000 21 |
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Snippet | Background. Nonalcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease, and children with a body mass index (BMI) ≥95th... Nonalcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease, and children with a body mass index (BMI) ≥95th percentile are... |
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SubjectTerms | Age Antidiabetics Body Mass Index Canada - epidemiology Child Codes Comorbidity Cross-Sectional Studies Demographics Disease control Electronic health records Epidemiology Hepatitis Humans Laboratories Liver diseases Medical records Non-alcoholic Fatty Liver Disease - complications Non-alcoholic Fatty Liver Disease - diagnosis Non-alcoholic Fatty Liver Disease - epidemiology Obesity Obesity - epidemiology Patients Pediatrics Population Primary care Primary Health Care Rural areas Young adults |
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Title | Screening Patterns of Nonalcoholic Fatty Liver Disease in Children with Obesity in Canadian Primary Care: A Cross-Sectional Study |
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