Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Korea.
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
Sci Rep. 2021 Mar 23;11(1):6648. doi: 10.1038/s41598-021-86197-z.
The recent incidence and management patterns of alcohol-related liver disease (ARLD) are not well defined in Korea. We sought to evaluate the epidemiology of ARLD with regard to disease severity and alcohol cessation management after diagnosis. We performed an observational cohort study of standardized Common Data Model data from the Health Insurance Review and Assessment-National Patient Samples database between 2012 and 2016. The incidence and demographic properties of ARLD were extracted and divided into non-cirrhotic alcoholic liver disease (ALD) and alcoholic liver cirrhosis (ALC). ALC was compared with non-alcoholic cirrhosis by severity at diagnosis. The management patterns were captured by the initiation of pharmaco- and behavioral therapy for alcohol cessation. We analyzed data from 72,556 ALD to 7295 ALC patients. The ALD incidence was stable from 990 to 1025 per 100,000 people. In ALD, the proportion of patients who were ≥ 65 years old, the proportion of female patients, and the comorbidity index increased significantly during the study period (all P values < 0.001). ALC accounted for > 20% of all cirrhosis, with decompensation occurring twice as often as in non-alcoholic cirrhosis. The initiation of alcoholism management was stationary in ARLD, remaining at < 10% for both pharmacotherapy and behavioral therapy, regardless of severity or the site of diagnosis. The incidence of ARLD did not decrease during the study period. Moreover, an increasing trend in the proportion of people vulnerable to drinking was observed. Unfortunately, management for the cessation of alcohol use remains very low. The best way to manage ARLD should be evaluated in further study.
韩国目前尚不清楚与酒精相关的肝病（ARLD）的发病率和管理模式。我们旨在评估 ARLD 的流行病学，包括疾病严重程度和确诊后的酒精戒断管理。我们对 2012 年至 2016 年间健康保险审查和评估-国家患者样本数据库中的标准化通用数据模型数据进行了观察性队列研究。提取了 ARLD 的发病率和人口统计学特征，并将其分为非肝硬化性酒精性肝病（ALD）和酒精性肝硬变（ALC）。根据诊断时的严重程度，将 ALC 与非酒精性肝硬化进行比较。通过开始药物和行为治疗以戒除酒精来捕获管理模式。我们分析了 72556 例 ALD 和 7295 例 ALC 患者的数据。ALD 的发病率从 990 人至 1025 人/100000 人保持稳定。在 ALD 中，≥65 岁患者的比例、女性患者的比例和合并症指数在研究期间显著增加（所有 P 值均<0.001）。ALC 占所有肝硬化的比例超过 20%，且失代偿的发生频率是非酒精性肝硬化的两倍。ARLD 的戒酒管理保持静止，药物治疗和行为治疗的启动率均<10%，无论严重程度或诊断部位如何。在研究期间，ARLD 的发病率没有下降。此外，观察到易饮酒人群的比例呈上升趋势。不幸的是，戒酒管理仍然非常低。应在进一步的研究中评估管理 ARLD 的最佳方法。
