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Cirrhosis more common in US now vs. earlier years

In a population-based study, cirrhosis was found to be more prevalent in the general US population now compared with earlier times, with most cases resulting from hepatitis, diabetes and alcohol abuse.

“We hypothesized that cirrhosis is more common than previously recognized, primarily because of a large amount of undiagnosed cryptogenic cirrhosis among individuals with risk factors for [nonalcoholic fatty liver disease],” the researchers wrote. 

Researchers, including Steven Scaglione, MD, assistant professor in the departments of medicine and public health sciences, Loyola University Chicago Stritch School of Medicine, analyzed data from the National Health and Nutrition Examination Survey conducted between 1999 and 2010 and connected it with data from the National Center for Health Statistics-linked death certificate, to determine the prevalence of cirrhosis and factors influencing its development.

Steven Scaglione

Cirrhosis was found to be prevalent in 0.27% of adults (n=633,323), and prevalence increased as the adults aged, leading to a 0.57% prevalence of cirrhosis in adults aged 45 to 54 years. Of the participants diagnosed, 69% reported they were unaware they had liver disease, according to the research. Fifty-three percent of all cases were related to previous diagnosis of viral hepatitis, diabetes or alcohol abuse.

Two-year mortality rates were greater among participants with cirrhosis compared with matched controls (26.4% vs. 8.4%). Furthermore, the disease was more prevalent in non-Hispanic blacks, Mexican Americans, those who had less than a 12th-grade education and those below the poverty level.

Multivariate and univariate analyses showed multiple factors to be independently associated with cirrhosis, including diabetes (OR=2.59; 95% CI, 1.4-4.78), alcohol abuse (OR=2.61; 95% CI, 1.26-5.39), hepatitis B virus (OR=7.4; 95% CI, 1.8-30.34), hepatitis C virus (OR=50.16; 95% CI, 27.7-90.8), male sex (OR=2.44; 95% CI, 1.43-4.16) and older age (OR=1.02; 95% CI, 1.003-1.04).   

“The prevalence of cirrhosis is higher than previously estimated,” the researchers concluded. “Many cases may be undiagnosed and more than half are potentially preventable by controlling diabetes, alcohol abuse and viral hepatitis. Public health efforts are needed to reduce this disease burden, particularly among racial and ethnic minorities and individuals at lower socioeconomic status.”

Disclosure: The researchers report no relevant financial disclosures.