The hidden epidemic : Uncovering incidental fatty liver disease and its metabolic comorbidities by datamining in a hospital data lake – A real-world cohort study
(2024) In Diabetes Research and Clinical Practice 210.- Abstract
 Aims: To identify individuals with incidental fatty liver disease (FLD), and to evaluate its prevalence, metabolic co-morbidities and impact on follow-up. Methods: We leveraged the data-lake of Helsinki Uusimaa Hospital district (Finland) with a population of 1.7 million (specialist and primary care). A phrase recognition script on abdominal imaging reports (2008–2020) identified/excluded FLD or cirrhosis; we extracted ICD-codes, laboratory and BMI data. Results: Excluding those with other liver diseases, the prevalence of FLD was 29% (steatosis yes/no, N=61,271/155,521; cirrhosis, N=3502). The false positive and negative rates were 5–6%. Only 1.6% of the FLD cases had the ICD code recorded and 32% had undergone full clinical evaluation... (More)
Aims: To identify individuals with incidental fatty liver disease (FLD), and to evaluate its prevalence, metabolic co-morbidities and impact on follow-up. Methods: We leveraged the data-lake of Helsinki Uusimaa Hospital district (Finland) with a population of 1.7 million (specialist and primary care). A phrase recognition script on abdominal imaging reports (2008–2020) identified/excluded FLD or cirrhosis; we extracted ICD-codes, laboratory and BMI data. Results: Excluding those with other liver diseases, the prevalence of FLD was 29% (steatosis yes/no, N=61,271/155,521; cirrhosis, N=3502). The false positive and negative rates were 5–6%. Only 1.6% of the FLD cases had the ICD code recorded and 32% had undergone full clinical evaluation for associated co-morbidities. Of the 35–65-year-old individuals with FLD, 20% had diabetes, 42% prediabetes and 28% a high liver fibrosis index. FLD was independently predicted by diabetes (OR 1.56, CI 1.46–1.66, p = 2.3 * 10^-41), BMI (1.46, 1.42–1.50, p = 1.7 * 10^-154) and plasma triglyceride level (1.5, 1.43–1.57, p = 3.5 * 10^-68). Alanine aminotransferase level mildly increased (1.12, 1.08–1.16, p = 2.2 * 10^-9) and high age decreased the risk (0.92, 0.89–0.94, p = 4.65*10^-09). Half of the cases had normal ALT. Conclusions: The incidental radiological finding of FLD is reliable and associated with metabolic risks but largely ignored, although it should lead to metabolic and hepatic follow-up.
(Less)
- author
 - 						Karhiaho, Iiro P.
	; 						Kurki, Samu H.
	; 						Parviainen, Helka I.
	; 						Kullamaa, Liisa
	; 						Färkkilä, Martti A.
	; 						Matikainen, Niina
	 and 						Tuomi, Tiinamaija
				LU
				
	 - organization
 - publishing date
 - 2024-04
 - type
 - Contribution to journal
 - publication status
 - published
 - subject
 - keywords
 - Diabetes, Dyslipidemia, Fatty liver disease, Screening
 - in
 - Diabetes Research and Clinical Practice
 - volume
 - 210
 - article number
 - 111609
 - publisher
 - Elsevier
 - external identifiers
 - 
                
- scopus:85187996781
 - pmid:38479446
 
 - ISSN
 - 0168-8227
 - DOI
 - 10.1016/j.diabres.2024.111609
 - language
 - English
 - LU publication?
 - yes
 - id
 - 7650c45c-7001-4f9e-929a-0faebf18d891
 - date added to LUP
 - 2024-04-03 08:47:53
 - date last changed
 - 2025-10-31 15:50:10
 
@article{7650c45c-7001-4f9e-929a-0faebf18d891,
  abstract     = {{<p>Aims: To identify individuals with incidental fatty liver disease (FLD), and to evaluate its prevalence, metabolic co-morbidities and impact on follow-up. Methods: We leveraged the data-lake of Helsinki Uusimaa Hospital district (Finland) with a population of 1.7 million (specialist and primary care). A phrase recognition script on abdominal imaging reports (2008–2020) identified/excluded FLD or cirrhosis; we extracted ICD-codes, laboratory and BMI data. Results: Excluding those with other liver diseases, the prevalence of FLD was 29% (steatosis yes/no, N=61,271/155,521; cirrhosis, N=3502). The false positive and negative rates were 5–6%. Only 1.6% of the FLD cases had the ICD code recorded and 32% had undergone full clinical evaluation for associated co-morbidities. Of the 35–65-year-old individuals with FLD, 20% had diabetes, 42% prediabetes and 28% a high liver fibrosis index. FLD was independently predicted by diabetes (OR 1.56, CI 1.46–1.66, p = 2.3 * 10^-41), BMI (1.46, 1.42–1.50, p = 1.7 * 10^-154) and plasma triglyceride level (1.5, 1.43–1.57, p = 3.5 * 10^-68). Alanine aminotransferase level mildly increased (1.12, 1.08–1.16, p = 2.2 * 10^-9) and high age decreased the risk (0.92, 0.89–0.94, p = 4.65*10^-09). Half of the cases had normal ALT. Conclusions: The incidental radiological finding of FLD is reliable and associated with metabolic risks but largely ignored, although it should lead to metabolic and hepatic follow-up.</p>}},
  author       = {{Karhiaho, Iiro P. and Kurki, Samu H. and Parviainen, Helka I. and Kullamaa, Liisa and Färkkilä, Martti A. and Matikainen, Niina and Tuomi, Tiinamaija}},
  issn         = {{0168-8227}},
  keywords     = {{Diabetes; Dyslipidemia; Fatty liver disease; Screening}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Diabetes Research and Clinical Practice}},
  title        = {{The hidden epidemic : Uncovering incidental fatty liver disease and its metabolic comorbidities by datamining in a hospital data lake – A real-world cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.diabres.2024.111609}},
  doi          = {{10.1016/j.diabres.2024.111609}},
  volume       = {{210}},
  year         = {{2024}},
}