Risk factors for nonalcoholic steatohepatitis in cryptogenic cirrhosis

Abstract

-Context -In about 10% of patients with chronic liver disease, it is not possible to identify an etiologic factor. These cases are called cryptogenic cirrhosis. Currently, nonalcoholic steatohepatitis (NASH) is being considered as a possible etiologic factor for a significant segment of patients that presents with cryptogenic cirrhosis. Objective -To estimate the prevalence of risk factors for NASH in patients with cryptogenic cirrhosis, in order to verify if there is a causal relationship between them. Method -Cross-sectional study, with evaluation of the demographic and laboratorial data of patients with cryptogenic cirrhosis. They were compared with data obtained from a group with NASH and a group with alcoholic and/or hepatitis C (HCV) cirrhosis. Results -Forty seven patients with cryptogenic cirrhosis were evaluated, 47 with NASH and 196 with HCV and/or alcoholic cirrhosis. The mean age of patients with cryptogenic cirrhosis was 52 years, while in those with NASH it was 46.4 years (P = 0,041). The group with cryptogenic cirrhosis had 23 female and 24 male patients. Of the patients who presented with NASH, 68.1% were female. Of the patients who presented with alcoholic/HCV cirrhosis, 64.8% were male. There were no statistically significant differences between the groups. In cryptogenic cirrhosis patients, the following prevalences could be observed: impaired fasting glycemia -68.2%; obesity -27.5%; total hypercholesterolemia -27.9%; low HDL levels -58.1% (women -81%; men -36.4%); hypertriglyceridemia -16.3%. The results seen in cryptogenic cirrhosis patients showed statistical similarity with the results of the NASH group regarding fasting glycemia (62.8%) and male HDL levels (53.8%). The comparison with the alcoholic/HCV cirrhosis group showed statistical differences regarding fasting glycemia (45.2%), hypercholesterolemia (13.3%) and female HDL levels (50.8%). Conclusions -It is not possible to establish a causal relationship between cryptogenic cirrhosis and NASH. Only data related to fasting glycemia and HDL levels in male patients showed statistical similarities between both groups of patients. HEADINGS -Liver cirrhosis. Fatty liver. Metabolic diseases.Declared conflict of interest of all authors: none.

Seropositive Form of Occult Hepatitis B Virus Infection in Iranian Patients with Cryptogenic Liver Cirrhosis

“…In the present study, cryptogenic cirrhosis was found more commonly in male recipients (63%); this is compatible with the findings of previous studies (22,30,31) yet in disagreement with others (32,33). As expected, HBsAg was not detected in patients with cryptogenic cirrhosis.…”

Unexplained Liver Damage, Cryptogenic Liver Cirrhosis, and Steatohepatitis May Be Caused by Latent Chronic Toxoplasmosis

“…This chronic liver disease with so far not established particular etiology accounts for 5-30% of cases of cirrhosis and about 10% of liver transplants [63][64][65] . In Germany, presumed cryptogenic liver disease (probably an early phase of liver cirrhosis) was found to be associated with high prevalence of autoantibodynegative autoimmune hepatitis, low prevalence of nonalcoholic steatohepatitis (NASH), and no evidence for occult viral etiology [66] .…”

“…non-B, non-C viral hepatitis (hepatitis X), and occult past ethanol exposure [64] . Leite et al [63] reported that in their 47 patients with CLC, the following prevalences were demonstrated: impaired fasting glycemia (68%), low HDL levels (58.1%), total hypercholesterolemia (27.9%), hypertriglyceridemia (16.3%), and obesity (27.5%). The results obtained in the patients with CLC showed statistical similarity with the data of the NASH group regarding fasting glycemia (62.8%) and HDL levels (53.8%, males) [63] .…”

“…Leite et al [63] reported that in their 47 patients with CLC, the following prevalences were demonstrated: impaired fasting glycemia (68%), low HDL levels (58.1%), total hypercholesterolemia (27.9%), hypertriglyceridemia (16.3%), and obesity (27.5%). The results obtained in the patients with CLC showed statistical similarity with the data of the NASH group regarding fasting glycemia (62.8%) and HDL levels (53.8%, males) [63] . Caldwell et al [67] found that among their 70 consecutive patients with cryptogenic cirrhosis, both diabetes type 2 and obesity (73% of individuals) were significantly more common compared with the cirrhotic patients with primary biliary cirrhosis or hepatitis C. It must be noted that among 567 patients with chronic liver disease evaluated by Kodali et al [68] , 28 individuals (4.9%) had no established a definite etiology, and nearly half of the patients with presumed CLC (13 of them, 46%) had a history of previous blood transfusion, thus supporting the hypothesis of a non-A, non-B, and non-C hepatitis virus.…”

Το Διαλυτό CD146 Ως Πρωτότυπος Ενθοθηλιακός Δείκτης, Σχετίζεται Με Την Βαρύτητα Της Ηπατικής Νόσου Και Την Εξέλιξη Σε Κίρρωση

“…Ζ δηάγλσζε εληζρχεηαη απφ ηελ έιιεηςε θιάζκαηνο ησλ α 1 ζθαηξηλψλ ζηελ ειεθηξνθφξεζε ιεπθσκάησλ θαη επηβεβαηψλεηαη κε ηνλ πξνζδηνξηζκφ ηεο α1-αληηζξπςίλεο ζηνλ νξφ ηνπ64 1.3.8 Κίξξσζε απόηνθνο θιεβηθήο ζηάζεο θαη θαξδηαθήο αλεπάξθεηαοΖ θιεβναπνθξαθηηθή λφζνο , ην ζχλδξνκν Budd -Chiari αιιά θαη ε ρξφληα δεμηά θαξδηαθή αλεπάξθεηα ζηα πιαίζηα πλεπκνληθήο θαξδίαο ή πλεπκνληθήο ππέξηαζεο ή ε ζπκπηεζηηθή πεξηθαξδίηηδα, νδεγνχλ ζηελ ζπκθνξεηηθή επαηηθή ίλσζε εμαηηίαο παξαηεηακέλεο θιεβηθήο ζηάζεο πνπ κπνξεί λα νδεγήζνπλ ζε θίξξσζε ηνπ ήπαηνο 68,69. 1.3.9 Κξπςηγελήο θίξξσζεΣέινο, ζε έλα πνζνζηφ αζζελψλ πνπ θπκαίλεηαη απφ 3-10% δελ είλαη δπλαηφλ λα αλαγλσξηζηεί αηηηνινγία ηεο θίξξσζεο 70. Έλα κέξνο απηψλ απνδίδεηαη ζε κε αιθννιηθή ζηεαηνεπαηίηηδα, θαζψο φηαλ δηαγλσζηεί ε θίξξσζε νη αζζελείο δελ έρνπλ πιένλ ηππηθά ηζηνινγηθά ραξαθηεξηζηηθά πνπ λα επηηξέπνπλ ηελ θιηληθή αλαγλψξηζε 51.…”