Objectives Remotely living Indigenous Australians have a disproportionate mortality from cirrhosis and hepatocellular cancer (HCC). However, there are no local population studies examining the prevalence of chronic liver disease (CLD) in remote communities. The main aims of this study were therefore to study a remote Indigenous population to determine the prevalence of CLD risk factors and the prevalence of significant fibrosis as defined by an Fibrosis-4 (FIB-4) score of ≥2.67. Methods The study design was a retrospective analysis of an electronic medical record database of a remote Aboriginal community-controlled health service. The setting was an Aboriginal community-controlled health service located in a remote South Australian town with a 15% Indigenous Australian population. Participants were all adult Indigenous Australians between the ages of 35 and 65 years. Results 83.9% of the study population had at least one CLD risk factor and 45% of the population had multiple CLD risk factors. The most prevalent risk factors were alcohol misuse, diabetes and obesity. 3.7% of the population had a high risk of significant fibrosis with an FIB-4 score≥2.67. Each additional CLD risk factor was associated with a 12.3% increase in FIB-4 mean (p=0.001). Conclusions CLD risk factors and significant liver fibrosis were highly prevalent in this population. Integrating simple liver screening tests into adult health checks has the potential to detect CLD at an early and treatable stage and to reduce the high morbidity and mortality from cirrhosis and HCC experienced by remotely living Indigenous Australians. Data are available upon reasonable request.

中文翻译：

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偏远地区澳大利亚原住民人群慢性肝病危险因素和肝纤维化患病率的横断面研究


目标 居住在偏远地区的澳大利亚原住民因肝硬化和肝细胞癌 (HCC) 死亡率过高。然而，尚无当地人口研究调查偏远社区慢性肝病 (CLD) 的患病率。因此，本研究的主要目的是研究偏远土著人口，以确定 CLD 危险因素的患病率以及纤维化 4 (FIB-4) 评分≥2.67 定义的显着纤维化的患病率。方法 研究设计是对偏远原住民社区控制的卫生服务的电子病历数据库的回顾性分析。地点是原住民社区控制的医疗服务机构，位于南澳大利亚州的一个偏远小镇，该镇的澳大利亚原住民人口占 15%。参与者均为年龄在 35 岁至 65 岁之间的成年澳大利亚原住民。结果 83.9% 的研究人群具有至少一种 CLD 危险因素，45% 的人群具有多种 CLD 危险因素。最常见的危险因素是滥用酒精、糖尿病和肥胖。 3.7% 的人群存在显着纤维化的高风险，且 FIB-4 评分≥2.67。每增加一个 CLD 风险因素，FIB-4 平均值就会增加 12.3%（p=0.001）。结论 CLD 危险因素和显着的肝纤维化在该人群中非常普遍。将简单的肝脏筛查测试纳入成人健康检查有可能在早期和可治疗阶段发现慢性肺病，并降低居住在偏远地区的澳大利亚原住民因肝硬化和肝癌而导致的高发病率和死亡率。数据可根据合理要求提供。