{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T03:04:14Z","timestamp":1765422254330,"version":"3.28.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"award":["K24AG065525"],"award-info":[{"award-number":["K24AG065525"]}]},{"award":["T32HL098048"],"award-info":[{"award-number":["T32HL098048"]}]},{"award":["K08DK115883","K23DK083439"],"award-info":[{"award-number":["K08DK115883","K23DK083439"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>Cirrhosis, a rising cause of death in the United States, has an extended preclinical phase characterized by progressive liver fibrosis. Despite the developments in noninvasive fibrosis measurement, there is no recommended screening, in part due to an incomplete understanding of the disease epidemiology on a national scale. Herein, we aim to define the prevalence of liver fibrosis and compare strategies to identify the at\u2010risk population. We analyzed 4,510 US adults with complete liver stiffness measurement (LSM) by vibration\u2010controlled transient elastography (VCTE) in the 2017\u20102018 National Health and Nutrition Examination Survey to estimate the disease burden of increased liver stiffness. An estimated 11.6 million (95% confidence interval [C.I.], 8.1\u201015.0 million) US adults had LSM \u22659.5 kPa, indicating advanced fibrosis and representing 1 in every 18 adults. Among them, 7.1 million (95% CI, 5.0\u20109.1 million) had LSM \u226512.5 kPa, which is concerning for cirrhosis. LSM \u22659.5 kPa is associated with male sex (S), history of other liver diseases (O), diabetes (D), advanced age (A), and an elevated BMI (B). A simple SODA\u20102B score had a sensitivity of 96.4% in identifying individuals at risk for advanced cirrhosis (LSM \u22659.5 kPa) and a negative predictive value of 99.3% in stratifying more than half of the adult population. When the liver function test (LFT) is available, the inclusion of abnormal LFT and elevated fibrosis\u20104 index can further increase screening efficiency. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Elevated liver stiffness is prevalent among US adults. A SODA\u20102B score can risk stratify adults for VCTE\u2010based fibrosis screening.<\/jats:p>","DOI":"10.1002\/hep4.1837","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T06:35:57Z","timestamp":1635230157000},"page":"898-909","update-policy":"http:\/\/dx.doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence of High Liver Stiffness and a Screening Strategy Using the SODA\u20102B Score Among US Adults"],"prefix":"10.1097","volume":"6","author":[{"given":"Sebastian","family":"Niezen","sequence":"first","affiliation":[{"name":"Department of Medicine,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,MA,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elliot B.","family":"Tapper","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Department of Medicine,University of Michigan,Ann Arbor,MI,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirsh","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Medicine,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,MA,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Medicine,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,MA,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Curry","sequence":"additional","affiliation":[{"name":"Department of Medicine,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,MA,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth J.","family":"Mukamal","sequence":"additional","affiliation":[{"name":"Department of Medicine,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,MA,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z. Gordon","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Medicine,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,MA,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"key":"hep41837-bib-0001-20241115","doi-asserted-by":"crossref","first-page":"2650","DOI":"10.1016\/j.cgh.2019.07.060","article-title":"Contemporary epidemiology of chronic liver disease and cirrhosis","volume":"18","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"hep41837-bib-0002-20241115","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.1002\/hep.28812","article-title":"Time trends in the health care burden and mortality of acute on chronic liver failure in the United States","volume":"64","year":"2016","journal-title":"Hepatology"},{"key":"hep41837-bib-0003-20241115","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1038\/s41395-018-0365-4","article-title":"Trends in chronic liver disease\u2010related hospitalizations: a population\u2010based study","volume":"114","year":"2019","journal-title":"Am J Gastroenterol"},{"key":"hep41837-bib-0004-20241115","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1053\/j.gastro.2018.08.063","article-title":"Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2018","volume":"156","year":"2019","journal-title":"Gastroenterology"},{"key":"hep41837-bib-0005-20241115","article-title":"Cost\u2010effectiveness analysis: risk stratification of nonalcoholic fatty liver disease (NAFLD) by the primary care physician using the NAFLD fibrosis score","volume":"11","year":"2016","journal-title":"PLoS ONE"},{"key":"hep41837-bib-0006-20241115","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1053\/j.gastro.2020.07.050","article-title":"Screening for nonalcoholic fatty liver disease in persons with type 2 diabetes in the United States is cost\u2010effective: a comprehensive cost\u2010utility analysis","volume":"159","year":"2020","journal-title":"Gastroenterology"},{"key":"hep41837-bib-0007-20241115","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/j.cgh.2017.12.048","article-title":"High prevalence of liver fibrosis among European adults with unknown liver disease: a population\u2010based study","volume":"16","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"hep41837-bib-0008-20241115","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S2468-1253(19)30419-4","article-title":"Prevalence of steatosis and fibrosis in young adults in the UK: a population\u2010based study","volume":"5","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"hep41837-bib-0009-20241115","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1002\/hep.31608","article-title":"Hepatic fibrosis associates with multiple cardiometabolic disease risk factors: the framingham heart study","volume":"73","year":"2021","journal-title":"Hepatology"},{"journal-title":"Clin Gastroenterol Hepatol","article-title":"Transient elastography\u2010assessed hepatic steatosis and fibrosis are associated with body composition in the United States","year":"2021","key":"hep41837-bib-0010-20241115"},{"key":"hep41837-bib-0011-20241115","first-page":"1","article-title":"The National Health and Nutrition Examination Survey: sample design, 1999\u20102006","year":"2012","journal-title":"Vital Health Stat 2"},{"key":"hep41837-bib-0012-20241115","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7326\/0003-4819-137-1-200207020-00006","article-title":"Updated definitions of healthy ranges for serum alanine aminotransferase levels","volume":"137","year":"2002","journal-title":"Ann Intern Med"},{"key":"hep41837-bib-0013-20241115","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1002\/hep.24725","article-title":"Upper limits of normal for alanine aminotransferase activity in the United States population","volume":"55","year":"2012","journal-title":"Hepatology"},{"key":"hep41837-bib-0014-20241115","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/hep.21669","article-title":"FIB\u20104: an inexpensive and accurate marker of fibrosis in HCV infection. 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