Copyright
©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Oct 7, 2014; 20(37): 13546-13555
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13546
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13546
Table 1 Criteria for the etiological diagnosis of liver cirrhosis
Viral hepatitis |
Hepatitis B virus (HBV): positive for HBsAg for at least 6 mo |
Hepatitis C virus (HCV): positive for anti-HCV or HCV-RNA |
HBV + HCV: HBV overlap with HCV |
HBV + Hepatitis D virus (HDV): positive for HBsAg and anti-HDV |
Alcoholic cirrhosis |
The diagnosis was made by a history of alcohol use ( ≥ 40 g/d for males and ≥ 20 g/d for females or > 80 g/d within past 2 wk), physical examinations for signs of chronic liver disease, laboratory abnormalities [including elevation of aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transferase (GGT) and prothrombin time] or typical imaging features of fatty liver and cirrhosis and the exclusion of other causes of LC[10] |
Autoimmune diseases |
Autoimmune hepatitis (AIH)[11] |
Primary biliary cirrhosis (PBC)[12] |
AIH + PBC: AIH and PBC overlap syndrome |
Primary sclerosing cholangitis[13] |
Secondary biliary cirrhosis |
Established when compatible with the diagnosis of liver cirrhosis, excluding some common causes of LC and indicated by cholestatic biomarkers (such as elevated alkaline phosphatase and GGT) |
Metabolic diseases |
Wilson’s disease[14] |
Hereditary hemochromatosis[15] |
Non-alcoholic fatty liver disease[16] |
Others (amyloidosis, glycogen storage disease, etc.) |
Drugs |
Established when the liver function test abnormalities related to drug intake and other causes of LC were excluded[17] |
Vascular diseases |
Budd-Chiari syndrome[18] |
Cardiac[19] |
Parasite cirrhosis |
The diagnosis was based on clinical manifestations, epidemiologic features, and lab tests, excluding other types of LC; the diagnosis needed to be verified by a positive pathogenic finding |
Infantile hepatitis syndrome |
The diagnosis was based on criteria of Roberts[20] |
Mixed etiology |
HBV + Alcohol |
HBV + HCV + Alcohol |
Other known etiology |
Cases with a definite known etiology but not listed above |
Cryptogenic cirrhosis |
Diagnosed only after an extensive evaluation excluded recognizable etiologies[21] |
Table 2 Liver function characteristics of the study population n (%)
Male | 6719 (83.2) |
Mean age (yr) | 50.5 ± 13.0 |
Child-Pugh score | |
A | 2521 (31.2) |
B | 3369 (41.7) |
C | 2190 (27.1) |
Mean ± SD | 8.0 ± 2.3 |
MELD score (mean ± SD) | 15.3 ± 7.2 |
MELD: median (extreme) | 13.6 (6-65) |
Table 3 Etiology of the 8080 enrolled liver cirrhosis patients n (%)
Etiology | Total | Male | Female | P value |
(n = 8080) | (n = 6719) | (n = 1361) | ||
Viral hepatitis | 6514 (80.62) | 5489 (81.69) | 1025 (75.31) | < 0.001 |
HBV | 6239 (77.22) | 5316 (79.12) | 923 (67.82) | |
HCV | 226 (2.80) | 135 (2.01) | 91 (6.69) | |
HBV + HDV | 2 (0.02) | 2 (0.03) | 0 (0.00) | |
HBV + HCV | 47 (0.58) | 36 (0.54) | 11 (0.81) | |
Alcohol | 459 (5.68) | 451 (6.71) | 8 (0.59) | < 0.001 |
Autoimmune | 163 (2.03) | 30 (0.43) | 133 (9.77) | < 0.001 |
AIH | 54 (0.67) | 13 (0.19) | 41 (3.01) | |
PBC | 87 (1.08) | 15 (0.22) | 72 (5.29) | |
AIH + PBC | 19 (0.24) | 1 (0.01) | 18 (1.32) | |
PSC | 3 (0.04) | 1 (0.01) | 2 (0.15) | |
Secondary biliary | 38 (0.47) | 22 (0.33) | 16 (1.18) | < 0.001 |
Metabolic diseases | 114 (1.40) | 73 (1.09) | 41 (3.02) | < 0.001 |
WD | 106 (1.31) | 67 (1.00) | 39 (2.87) | |
HH | 2 (0.02) | 2 (0.03) | 0 (0.00) | |
NAFLD | 4 (0.05) | 2 (0.03) | 2 (0.15) | |
Others | 2 (0.02) | 2 (0.03) | 0 (0.00) | |
Drugs | 9 (0.11) | 6 (0.09) | 3 (0.22) | 0.186 |
Vascular diseases | 46 (0.57) | 30 (0.44) | 16 (1.17) | 0.001 |
BCS | 31 (0.38) | 21 (0.31) | 10 (0.73) | |
Cardiac | 15 (0.19) | 9 (0.13) | 6 (0.44) | |
Parasites | 33 (0.41) | 26 (0.39) | 7 (0.51) | 0.502 |
IHS | 8 (0.10) | 7 (0.10) | 1 (0.07) | 1.000 |
Mixed etiology | 400 (4.95) | 399 (5.93) | 1 (0.07) | < 0.001 |
HBV + Alcohol | 389 (4.81) | 388 (5.77) | 1 (0.07) | |
HBV + HCV + Alcohol | 11 (0.14) | 11 (0.16) | 0 (0.00) | |
Other known etiology | 59 (0.73) | 51 (0.76) | 8 (0.58) | 0.499 |
Cryptogenic cirrhosis | 237 (2.93) | 135 (2.01) | 102 (7.49) | < 0.001 |
Table 4 Etiology of the 8080 liver cirrhosis patients by age
Etiology | Age, yr | ||
LC classification | mean ± SD | t value | P value |
Viral hepatitis | 50.7 ± 12.4 | ||
Alcohol | 52.2 ± 11.0 | -1.48 | 0.308 |
Autoimmune | 54.3 ± 12.9 | -3.66 | 0.029 |
Secondary biliary | 46.3 ± 25.1 | 4.33 | 1.000 |
Metabolic diseases | 27.2 ± 14.1 | 23.49 | < 0.001 |
Drugs | 56.0 ± 18.2 | -5.33 | 1.000 |
Vascular diseases | 42.8 ± 17.6 | 7.87 | 0.212 |
Parasites | 58.1 ± 14.9 | -7.42 | 0.319 |
IHS | 2.5 ± 3.9 | 48.18 | < 0.001 |
Mixed etiology | 51.2 ± 9.7 | -0.52 | 1.000 |
Other known etiology | 44.7 ± 13.6 | 5.98 | 0.079 |
Cryptogenic cirrhosis | 55.0 ± 17.5 | -4.29 | 0.015 |
Table 5 Etiologic analysis for the years 2001-2005 and the years 2006-2010 n (%)
Etiology | 2001-2005 (n = 2907) | 2006-2010 (n = 5173) | χ2-value | P value | P-trend |
Viral hepatitis | 2462 (84.7) | 4052 (78.3) | 48.22 | < 0.001 | < 0.001 |
HBV | 2381 (81.9) | 3858 (74.6) | 56.78 | < 0.001 | < 0.001 |
HCV | 67 (2.3) | 159 (3.1) | 4.05 | 0.044 | 0.263 |
HBV + HCV | 12 (0.4) | 35 (0.7) | 2.24 | 0.135 | 0.267 |
HBV + HDV | 2 (0.1) | 0 (0.0) | - | 0.129 | - |
Alcohol | 155 (5.3) | 304 (5.9) | 1.031 | 0.31 | 0.919 |
Autoimmune | 34 (1.2) | 129 (2.5) | 16.509 | < 0.001 | < 0.001 |
Secondary biliary | 12 (0.4) | 26 (0.5) | 0.321 | 0.571 | 0.369 |
Metabolic diseases | 32 (1.1) | 82 (1.6) | 3.139 | 0.076 | 0.07 |
Drugs | 1 (0.0) | 8 (0.2) | 1.459 | 0.227 | 0.161 |
Vascular diseases | 17 (0.6) | 29 (0.6) | 0.019 | 0.89 | 0.551 |
Parasites | 14 (0.5) | 19 (0.4) | 0.598 | 0.439 | 0.154 |
IHS | 2 (0.1) | 6 (0.1) | 0.078 | 0.78 | 0.696 |
Mixed etiology | 87 (3.0) | 313 (6.1) | 36.984 | < 0.001 | < 0.001 |
Other known etiology | 16 (0.5) | 43 (0.8) | 2.95 | 0.086 | 0.285 |
Cryptogenic cirrhosis | 75 (2.6) | 162 (3.1) | 1.989 | 0.158 | 0.011 |
Table 6 Complications in the 8080 liver cirrhosis patients by gender n (%)
Complication | Total(n = 8080) | Male(n = 6719) | Female(n = 1361) | χ2value | P value |
UGIB | 1006 (12.5) | 875 (13.0) | 131 (9.6) | 12.00 | 0.001 |
Infection | 2177 (26.9) | 1806 (26.9) | 371 (27.3) | 0.08 | 0.773 |
Ascites | 4493 (55.6) | 3739 (55.6) | 754 (55.4) | 0.03 | 0.867 |
HCC | 2399 (29.7) | 2157 (32.1) | 242 (17.8) | 111.21 | < 0.001 |
HE | 544 (6.7) | 464 (6.9) | 80 (5.9) | 1.90 | 0.168 |
PVT | 405 (5.0) | 342 (5.1) | 63 (4.6) | 0.51 | 0.477 |
PVTT | 783 (9.7) | 733 (10.9) | 50 (3.7) | 67.7 | < 0.001 |
CTPV | 250 (3.1) | 229 (3.4) | 21 (1.5) | 13.13 | < 0.001 |
HRS | 293 (3.6) | 252 (3.8) | 41 (3.0) | 1.76 | 0.184 |
HPS | 6 (0.1) | 4 (0.1) | 2 (0.1) | 1.17 | 0.280 |
HHT | 398 (4.9) | 337 (5.0) | 61 (4.5) | 0.69 | 0.407 |
Table 7 Odds ratios of the different etiologies with respect to the complications of upper gastrointestinal bleeding
Complication | HBV cirrhosis | HCV cirrhosis | Alcoholic cirrhosis | Autoimmune cirrhosis | Mixed etiology | Cryptogenic cirrhosis | Others |
(n = 6239) | (n = 226) | (n = 459) | (n = 163) | (n = 400) | (n = 237) | (n = 356) | |
UGIB (Y/N) | 739/5500 | 24/202 | 98/361 | 16/147 | 47/353 | 41/196 | 41/315 |
OR | 1.00 | 1.07 | 1.89 | 0.90 | 0.83 | 1.76 | 1.01 |
95%CI | 0.68-1.69 | 1.48-2.41 | 0.50-1.60 | 0.60-1.16 | 1.21-2.52 | 0.72-1.44 | |
P value | 0.759 | < 0.001 | 0.713 | 0.282 | 0.002 | 0.938 |
Table 8 Odds ratios of different etiologies with respect to the complications of hepatocellular carcinoma
Complication | HBV cirrhosis | HCV cirrhosis | Alcoholic cirrhosis | Autoimmune cirrhosis | Mixed etiology | Cryptogenic cirrhosis | Others |
(n = 6239) | (n = 226) | (n = 459) | (n = 163) | (n = 400) | (n = 237) | (n = 356) | |
HCC (Y/N) | 2118/4121 | 51/175 | 41/418 | 4/159 | 97/303 | 57/180 | 325/31 |
OR | 1.00 | 0.54 | 0.16 | 0.05 | 0.58 | 0.60 | 0.20 |
95%CI | 0.38-0.75 | 0.11-0.22 | 0.02-0.17 | 0.45-0.74 | 0.44-0.83 | 0.13-0.31 | |
P value | < 0.001 | < 0.001 | < 0.001 | < 0.001 | 0.002 | < 0.001 |
- Citation: Wang X, Lin SX, Tao J, Wei XQ, Liu YT, Chen YM, Wu B. Study of liver cirrhosis over ten consecutive years in Southern China. World J Gastroenterol 2014; 20(37): 13546-13555
- URL: https://www.wjgnet.com/1007-9327/full/v20/i37/13546.htm
- DOI: https://dx.doi.org/10.3748/wjg.v20.i37.13546