Metabolic Co-Morbidities and Higher Risk of Advanced Fibrosis in Patients with Nonalcoholic Steatohepatitis

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WHO:

Dr. Gish is a Hepatologist specializing in all forms of liver disease, liver cancer and liver transplant. Dr. Gish has partnered with TeleMed2U to provide telemedicine consultative services for patients with liver disease.

WHAT:

TeleMed2U is a telemedicine-based multi-specialty clinical practice increasing access to specialist providers providing, “healthcare anywhere and everywhere.” The telemedicine consultation will be conducted through our HIPAA and HITECH compliant platform. Connectivity testing will be done in advance to ensure you can connect via our telemedicine platform. Following the consultation, a clinical note will be provided including a summary of your liver consultation with Dr. Gish and his consultative recommendations.

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Payment will be processed through an online secure transaction portal. The fees for consultative services are:

Initial 60 minute consultation per patient: $500.00
Follow Up 30 minute consultation per patient: $300.00

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Metabolic Co-Morbidities and Higher Risk of Advanced Fibrosis in Patients with Nonalcoholic Steatohepatitis

Jan 6, 2020

Increasing Number of Metabolic Co-Morbidities are Associated with Higher Risk of Advanced Fibrosis in Patients with Nonalcoholic Steatohepatitis

Abstract
Background and aims: Accurate estimates of non-alcoholic steatohepatitis (NASH) prevalence are lacking, particularly the subset of patients with advanced fibrosis. We aim to evaluate prevalence and predictors of advanced fibrosis among patients with probable NASH using national clinical laboratory data.

Method: Clinical laboratory data from October 1, 2017-September 30, 2018 were collected using Quest Diagnostics database, which tests ∼30% of U.S. adults annually. Adults with negative hepatitis B surface antigen, negative hepatitis C antibody, and elevated alanine aminotransferase (ALT) (>25 U/L women, >35 U/L men) were evaluated for prevalence of ≥F 3 fibrosis using fibrosis-4 score (FIB-4)>2.67.

Patients were grouped by presence of one, two, or three concurrent metabolic co-morbidities (decreased high density lipoprotein (<40 mg/dL in men, <50 mg/dL in women), elevated triglycerides (≥1 50 mg/dL), or elevated hemoglobin A1C (≥6 .5%)). We further evaluated patients specifically with NAFLD/NASH ICD-9/10 codes from October 1, 2013-Septebmer 30, 2018 (n = 243, 050). Multivariate logistic regression models evaluated for predictors of ≥F 3 fibrosis.

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