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Background and aim: Difficulties in accessing data from individual countries, especially Russia, hinder global evaluation of liver disease in Europe. The aim of this study is to estimate the prevalence of liver disease in Moscow, Russia’s capital and most densely populated urban area.
Methods: We recruited 5,000 random Moscow residents over the age of 18 in a population-based cross-sectional study. Participants were screened for liver disease between October 2012 and November 2012. Socio-demographic, health and lifestyle information was obtained via questionnaire; alcohol screening was done using CAGE and AUDIT tools; BMI was measured by physical exam; liver tests (ALT, AST, GGTP, bilirubin, ALP, ALT/AST), anti-HCV, HBsAg, and γ-globulins were checked by laboratory analysis; an abdominal ultrasound was performed for all patients. Provisional diagnoses were formed for all participants according to our established algorithm.
Results: In total, 4,768 participants completed screening. Socio-demographic data: male 1,671 (33.42%), female 3,329 (66.58%), average age 45 years, average BMI 26.2 kg/m2. Average BMI >25 kg/m2 was observed among the following occupational groups: retired, disabled, military and businessmen. Health care workers and students were the “slimmest” occupational groups, with only 24.7% and 21.8% having BMI >25 kg/m2 respectively. The CAGE and AUDIT questionnaires revealed that a huge number of participants (74.64% of all participants) should reduce the quantity of alcohol they consume, and that 9.8% abuse alcohol or are alcohol dependent. Overall, 1,459 subjects (30.6%, m:f=2:1) had at least one abnormality in liver function tests. We found the following prevalence of liver diseases in Russia’s largest city: NAFLD 7.4% (n=352), ALD 6.9% (n=329), hepatitis C 6.7% (n=322), hepatitis B 1.9% (n=91), DILI 0.82% (n=39), cholestasis 0.69% (n=33), AIH 0.78% (n=37), other forms of liver disease 5.4% (n=258).
Conclusions: According to our study, more than one quarter of Moscow residents have abnormal liver tests that may indicate liver disease. NAFLD, ALD and hepatitis C were the main causes of abnormal tests. The primary risk factors for abnormal liver tests as determined by multivariable analysis were: young age (30-59 years, p<0.001), alcohol abuse (AUDIT score >16, p<0.04), and hypercholesterolemia (p=0.016). 80.3% of patients with abnormal liver tests required etiotropic treatment.
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