Cryptogenic cirrhosis in the region where obesity is not prevalent

Table 1 Characteristics of cryptogenic cirrhotic patients and matched controls

	Cryptogenic(n=24)	Control; all(n=72)	HCV-related(n=48)	HBV-related(n=24)
Age (yr)	58.2  ±  10.6	58.6  ±  8.8	58.7  ±  8.1	58.3  ±  10.2
Child-Pugh score	6.3  ±  1.4	6.5  ±  1.2	6.5  ±  1.2	6.4  ±  1.3
Follow-up (yr)	5.7  ±  4.2	5.9  ±  4.4	6.5  ±  4.2	4.7  ±  4.5
Transfusion (%)	0	26.8 b	34.0 b	12.5
Body mass index (kg/m2)	25.5 ±  3.2	22.4 ± 3.0 b	22.6 ± 3.3 b	22.0 ± 2.4 b
ICGR15 (%)	31.5 ± 16.7	27.2 ± 12.3	28.2 ± 12.1	25.0 ± 12.7
Total bilirubin (mmol/L)	22 ± 15	21 ± 10	22 ± 10	19 ± 10
AST (nkat/L)	959 ± 572	1349 ± 772 a	1410 ± 573 b	1229 ± 1064
ALT (nkat/L)	860 ± 640	1229 ± 765 a	1359 ± 748 b	972 ± 747
AKP (nkat/L)	6518 ± 2942	6638 ± 2976	6695 ± 2577	6529 ± 3692
Albumin (g/L)	40 ± 5	38 ± 5	38 ± 5 b	38 ± 6
γ-globulin (g/L)	17 ± 3	18 ± 5	19 ± 4	15 ± 5
Cholinesterase (U/L)	242.8 ± 118.2	174.5 ± 67.8 b	162.1 ± 61.7 b	198.8 ± 73.7
Total cholesterol (mg/dL)	170.5 ± 43.0	156.5 ± 35.1	151.2 ± 31.3 b	166.8 ± 40.2
Triglyceride (mg/dL)	103.8 ± 44.2	83.0 ± 25.5 b	84.5 ± 26.6 b	80.1 ± 23.8 b
Prothrombin time (INR)	1.15 ± 0.15	1.19 ± 0.14	1.21 ± 0.14	1.16 ± 0.14
Hemoglobin A1c (%)	6.2 ± 1.3	5.1 ± 0.8 b	5.3 ± 0.9 a	4.8 ± 0.7 b
Blood glucose (mg/dL)	123.1 ± 48.2	96.4 ± 21.0 b	96.9 ± 23.0 b	95.2 ± 16.3 a
Insulin (mU/L)	26.8 ± 15.7	14.2 ± 6.4 b	15.9 ± 6.6 b	10.8 ± 4.5 b
HOMA-R (%)	8.6 ± 4.8	3.6 ± 2.5 b	4.0 ± 2.9 b	2.6 ± 1.3 b
QUICKI	0.29 ± 0.02	0.33 ± 0.03 b	0.32 ± 0.02 b	0.34 ± 0.04 b
Transferrin saturation (%)	36.3 ± 17.5	45.2 ± 29.7	48.5 ± 31.1	40.0 ± 27.8
Ferritin (mg/L)	160.0 ± 155.3	193.5 ± 282.9	225.0 ± 318.1	99.3 ± 104.8
Visceral fat area (cm2)	102.0 ± 39.8	56.9 ± 35.3 b	52.1 ± 30.7 a	64.3 ± 43.9 b
Liver/spleen ratio	1.08 ± 0.05	1.08 ± 0.06	1.07 ± 0.06	1.09 ± 0.06

^aP < 0.05, ^bP < 0.01 vs cryptogenic cirrhosis. ICGR15:indocyanine green retention rate, INR:international normalized ratio, HOMA-R:homeostasis model assessment parameter of insulin resistance, QUICKI: quantitative insulin check index.

Table 2 Prevalence of obesity and complication in cryptogenic cirrhotic patients and matched controls

	Cryptogenic(n=24)	Control; all(n=72)	HCV-related(n=48)	HBV-related(n=24)
Body mass index: ≥25kg/m2	54.2%	20.8%b	29.2%a	8.3%b
≥30kg/m2	16.7%	1.4%a	2.1%a	0%a
Visceral fat area: ≥100cm2	40.0%	5.3%b	3.7%b	9.1%a
Complication
Type 2 diabetes mellitus	54.2%	26.4%a	35.4%	13.3%b
Hypertriglyceridemia (≥150mg/dL)	20.8%	4.2%a	2.1%b	13.3%
Hypertension	25.0%	15.3%	18.8%	13.3%

^aP < 0.05, ^bP < 0.01 vs Cryptogenic cirrhosis.

Table 3 Factors associated with cryptogenic cirrhosis

	Odds ratio (95% CI)	P value
Univariate
Body mass index (≥25 kg/m2)	4.2 (1.51-11.48)	0.006
Visceral fat area (≥100 cm2)	12.8 (2.16-75.32)	0.005
Diabetes mellitus	3.3 (1.26-8.60)	0.015
Dyslipidemia	6.1 (1.33-27.64)	0.020
Hypertension	1.8 (0.60-5.70)	0.285
ALT (<667 nkat/L)	3.8 (1.42-9.91)	0.008
Cholinesterase (≥192 U/L)	3.9 (1.42-10.94)	0.008
Triglyceride (≥150 mg/dL)	5.9 (1.29-26.86)	0.022
Total cholesterol (≥220 mg/dL)	3.4 (0.77-14.62)	0.108
HbA1c (≥6%)	5.5 (1.40-21.75)	0.015
HOMA-R (≥4%)	11.6 (2.46-54.45)	0.002
Ferritin (≥220 ng/dL)	0.4 (0.11-1.82)	0.255
Transferrin saturation (≥40%)	0.4 (0.11-1.82)	0.158
Multivariate
HbA1c (≥6.0%)	7.8 (1.62-37.55)	0.010
Body mass index (≥25 kg/m2)	6.8 (1.41-32.87)	0.017
ALT (<40 U/L)	5.0 (1.12-22.43)	0.035

CI: confidence interval, ALT: alanine transaminase, HbA1c: hemoglobin A1c, HOMA-R: homeostasis model assessment parameter of insulin resistance.