Metabolic risk factors are a major comorbidity in patients with cirrhosis independent of the presence of hepatocellular carcinoma

被引:14
作者
Hessheimer, Amelia J. [1 ,2 ]
Forner, Alejandro [1 ]
Varela, Maria [1 ]
Bruix, Jordi [1 ]
机构
[1] Univ Barcelona, Hosp Clin, CIBEREHD, IDIBAPS,BCLC Grp,Liver Unit, E-08036 Barcelona, Spain
[2] Barnes Jewish Hosp, Dept Gen Surg, St Louis, MO 63110 USA
关键词
cryptogenic cirrhosis; hepatocellular carcinoma; metabolic risk factors; nonalcoholic fatty liver disease; NONALCOHOLIC FATTY LIVER; NATURAL-HISTORY; CRYPTOGENIC CIRRHOSIS; DISEASE; STEATOHEPATITIS; MANAGEMENT; POPULATION; OBESITY; CANCER; DIAGNOSIS;
D O I
10.1097/MEG.0b013e32833aa19b
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Recent studies have identified cases of hepatocellular carcinoma (HCC) arising in cryptogenic cirrhosis and proposed that many of them may be attributable to nonalcoholic fatty liver disease (NAFLD). Objective To evaluate the prevalence of NAFLD-ssociated metabolic risk factors among HCC patients to determine whether NAFLD could have played a role in the development of HCC. Methods Patients with HCC in the setting of hepatic cirrhosis and age-matched, sex-matched, and Child-Pugh-matched cirrhotic patients were included in this study. A verbal interview regarding family and personal history of metabolic risk factors; a complete physical examination, including morphometric measurements; and a blood analysis evaluating liver function and cirrhosis etiology were conducted with each patient. Results Seventy HCC patients and 64 tumor-free cirrhotics were included. Sixty-six patients (49%) were overweight and 37 (28%) obese, with a median body mass index of 27.6 (range: 19-41). Fifty-six patients (42%) had central adiposity, 62 (46%) had hypertension, 46 (34%) had type 2 diabetes, seven (5%) had coronary artery disease, and 48 (36%) had dyslipidemia. There were no significant differences in the distribution of metabolic risk factors between the groups. The main cause of cirrhosis was HCV in 83 patients (62%). In only two patients (1.4%), no cirrhosis etiology could be determined; both of them had HCC and metabolic risk factors. Conclusion Metabolic risk factors are a major health issue in patients with liver disease, regardless of the presence of HCC. Metabolic factors may have been risk factors for the development of liver disease and cirrhosis, even when other established causes of cirrhosis were present. Eur J Gastroenterol Hepatol 22: 1239-1244 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
引用
收藏
页码:1239 / 1244
页数:6
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