Characteristics of liver cirrhosis in Italy: results from a multicenter national study

Stroffolini, T.; Sagnelli, E.; Almasio, P.L.; Ferrigno, Luigina; Craxı̀, Antonio; Mele, Alfonso

doi:10.1016/j.dld.2003.07.007

Cited by 34 publications

(23 citation statements)

References 10 publications

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“…The rate of NASH cirrhosis in the present study (7.3%) is much higher than the 0.2% observed in the 2001 survey [6], likely reflecting an increased awareness of NASH as cause of cirrhosis.…”

Section: Discussioncontrasting

confidence: 51%

“…Several of the units participating in the present survey have participated even in the previous ones [5,6], so that results may be considered comparable overtime in terms of methodology adopted, area of residence of patients, and facility of access to a referral centre.…”

Section: Discussionmentioning

confidence: 99%

“…Two cross-sectional nationwide surveys performed in 1992 and in 2001 [5,6] have shown that HCV was present, even with other etiological factor, in 72.1% and 69.9% cirrhosis cases, respectively.…”

Section: Introductionmentioning

confidence: 99%

“…In the early 70s, HBV accounted for nearly one third of cirrhosis cases [3], a decade later its associated defective hepatitis delta virus (HDV) accounted for most cases of a so-called "juvenile cirrhosis" [4] and HCV has been found responsible of more than half of cirrhosis cases since its discovery in 1989 [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of liver cirrhosis in Italy: Evidence for a decreasing role of HCV aetiology

Stroffolini

Sagnelli

Gaeta

et al. 2017

European Journal of Internal Medicine

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Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Characteristics of liver cirrhosis in Italy: Evidence for a decreasing role of HCV aetiology

Stroffolini

Sagnelli

Gaeta

et al. 2017

European Journal of Internal Medicine

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“…5 In terms of fraction of liver diseases attributable to HDV, the weight of hepatitis D is still marginal. Indeed, 13% of cirrhosis cases are HBsAg-positive in Italy; 6 assuming that 10%-20% of these individuals are infected with HDV, the proportion of cases attributable to HDV ranges from 1%-2%.…”

mentioning

confidence: 99%

Hepatitis delta in Europe: Vanishing or refreshing?

et al. 2007

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We thank Dr. Targher, Dr. Manco, and their colleagues for their interest in our work. Both groups of investigators suggest that the existing literature and our observations regarding the correlation between the presence of dorsocervical lipohypertrophy (DCL) and severity of nonalcoholic steatohepatitis (NASH) indicate a dysfunction of the hypothalamic-pituitary axis (HPA). We completely agree with this assessment and had indeed suggested that this possibility should be systematically evaluated. 1 Although we agree with Dr. Targher that clinical assessment of DCL is somewhat subjective and thus suspect to variable interpretation, there are also no well-validated and universally accepted quantitative measures of the presence of DCL that perform better than subjective assessment alone. We would also like to point out that the issue is quite complex and requires consideration of several points: (1) Is HPA dysfunction a feature of the metabolic syndrome or a specific feature of nonalcoholic fatty liver disease (NAFLD)? It is well known that several clock genes are affected in the metabolic syndrome and that the hypothalamus plays an important role in circadian rhythms. 2 (2) Is HPA dysfunction required for the development of NAFLD, and does it contribute to the development of NASH? (3) What is the relationship of HPA dysfunction with the development of DCL? (4) How does DCL contribute to severity of NASH, for example, via cytokines, or is it simply a surrogate marker for more severe HPA dysfunction that drives NASH development or severity? These are currently the questions of greatest relevance in this area that need to be answered.We also agree that measurement of free cortisol and its suppression by dexamethasone may provide valuable information about HPA dysfunction in NAFLD. We would, however, caution that such studies must include evaluation of liver histology, which is the only reliable method for assessment of NASH severity.Finally, with respect to insulin resistance and cardiovascular risk profiles, we have reanalyzed our data as suggested by Dr. Manco. The waist circumference correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) in both females (r ϭ 0.66, P Ͻ 0.0001) and males (r ϭ 0.43, P Ͻ 0.03), but the hip circumference correlated significantly with HOMA-IR in females only (r ϭ 0.35, P Ͻ 0.008).In summary, we believe that the cumulative published data indicate that there is a subtle dysfunction of the HPA in NAFLD. These data raise several new questions that may provide important new information about the genesis of NAFLD and are thus worthy of investigation.

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Prevalence and etiology of altered liver tests: A population-based survey in a Mediterranean town

Pendino¹,

et al. 2005

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Characteristics of liver cirrhosis in Italy: results from a multicenter national study

Cited by 34 publications

References 10 publications

Characteristics of liver cirrhosis in Italy: Evidence for a decreasing role of HCV aetiology

Characteristics of liver cirrhosis in Italy: Evidence for a decreasing role of HCV aetiology

Hepatitis delta in Europe: Vanishing or refreshing?

Prevalence and etiology of altered liver tests: A population-based survey in a Mediterranean town

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