Prevalence and characteristics of metabolic dysfunction-associated steatohepatitis among pediatric patients in the MarketScan Databases

TL;DR

This study estimates the prevalence of MASH in children using healthcare databases, finding higher rates in Medicaid patients and those with obesity and diabetes.

Contribution

The study provides the first cross-sectional prevalence estimates of MASH in pediatric populations using large-scale healthcare databases.

Findings

MASH prevalence was 0.036% in Medicaid and 0.011% in Commercial databases.

MASH was more common in older children, males, and those with obesity or T2D.

Prevalence of MASH increases with age and comorbid conditions like metabolic syndrome.

Abstract

There are few epidemiologic studies of the prevalence of metabolic dysfunction-associated steatohepatitis (MASH) among pediatric populations.

To estimate the cross-sectional prevalence of MASH in the pediatric (<18 years) populations of MerativeTM MarketScan® Commercial Database (Commercial) and MerativeTM MarketScan® Multi-State Medicaid Database (Medicaid).

Pediatric patients with ≥1 medical encounter from 1/1/2020 to 12/31/2020 and ≥6 months of continuous enrollment before the most recent medical encounter were included. MASH was confirmed by an ICD-10-CM diagnosis code for MASH (K75.81) in the medical history since 1/1/2016.

A total of 1,476 and 410 pediatric MASH patients were identified in Medicaid and Commercial databases respectively, with a prevalence of 0.036% (95% confidence interval (CI): 0.034%, 0.038%) in Medicaid, as compared to 0.011% (95% CI: 0.010%, 0.012%) in Commercial. Prevalence of MASH increased by age. MASH was more prevalent in those who were male, obese, had T2D, and had metabolic syndrome. Among all pediatric MASH patients, the majority were ≥10 years old, male, and obese.

MASH is more prevalent among pediatric patients with comorbid conditions such as metabolic syndrome, obesity, and T2D, which appears to be similar to young adults. Rising prevalence of childhood obesity and related comorbid conditions, and the progressive nature of MASH, make this an area of increasing medical need. Prescreening MASH among high-risk patients with these comorbidities is needed for target intervention.

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