Influence of socioeconomic and cultural factors in the etiology of cirrhosis of the liver

Roesch-Dietlen, F.; González-Santes, M.; Sánchez-Maza, Y.J.; Díaz-Roesch, F.; Cano-Contreras, A.D.; Amieva-Balmori, Mercedes; García-Zermeño, Karla Rocío; Salgado-Vergara, L.; Remes-Troche, J.M.; Ortigoza-Gutiérrez, S.

doi:10.1016/j.rgmxen.2020.01.004

Cited by 4 publications

(5 citation statements)

References 28 publications

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“…The majority of the Hovyzeh cohort population had a low level of education. In univariate regression, people with secondary education were more likely to suffer from NAFLD; however, after controlling for confounding factors, this relationship was not significant, which is consistent with other studies [ 32 ]. A study in India showed no significant relationship between fatty liver disease and education level [ 50 ].…”

Section: Discussionsupporting

confidence: 89%

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Non-alcoholic fatty liver disease and socioeconomic determinants in an Iranian cohort study

Sadeghianpour,

Cheraghian,

Farshchi

et al. 2023

BMC Gastroenterol

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Background Non-alcoholic fatty liver disease (NAFLD) is widespread worldwide. On the other hand, social inequality and socioeconomic status (SES) can affect all aspects of health. Therefore, this study aimed to investigate the relationship between SES indicators and NAFLD. Methods This was a cross-sectional study using data from the registration phase of the Hoveyzeh Cohort Study, which included 10,009 individuals aged 35–70 years from May 2016 to August 2018. Fatty liver disease was determined based on Fatty Liver Index (FLI). The crude and adjusted odds ratios were calculated by logistic regression analysis to estimate associations between the fatty liver index and SES after controlling the potential confounders. Results According to the FLI index, there were 2,006 people with fatty liver (28%) and 5,246 people without fatty liver (72%). Several 4496 people (62%) were women. The chi-square test showed significant relationships between the educational level and skill level (P < 0.001), the wealth index (P < 0.001), and Townsend Index (P < 0.001) with fatty liver index. In multivariable analysis, after adjustment for age, sex, physical activity, smoking, type of residence, calorie intake, dyslipidemia, skill level, and diabetes, the wealth index (p < 0.001) was positively associated with the fatty liver index. Besides, a reverse and significant association was seen between the Townsend index and the fatty liver index(p < 0.001). In contrast, no significant associations were seen between gender and educational level with the fatty liver index. Conclusions A more vulnerable SES is associated with NAFLD. Fatty liver index and socioeconomic indicators can be powerful monitoring tools to monitor health differences in diagnosing NAFLD.

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Section: Discussionsupporting

confidence: 89%

“…Meanwhile, other studies showed different results. In several studies, men constituted the majority of patients with fatty liver disease [ 32 – 34 ]. This is probably attributed to differences in study design and subjects' ethnicities.…”

Section: Discussionmentioning

confidence: 99%

Non-alcoholic fatty liver disease and socioeconomic determinants in an Iranian cohort study

Sadeghianpour,

Cheraghian,

Farshchi

et al. 2023

BMC Gastroenterol

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“…According to previous studies, old people, men, Mexican Americans, and high-income individuals are likely to have MASLD [21–24]. Furthermore, other potential risk factors, such as health awareness, education level, and nutrition intake, have been reported and discussed in prior studies, but the association remains equivocal [23,25,26].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, trends, and characteristics of metabolic dysfunction-associated steatotic liver disease among the US population aged 12–79 years

Shen,

Wu,

Lee

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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Background and aims Clinical observation revealed an increase in metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence among adults and adolescents and young adults (AYA). However, its prevalence trend in specific subgroups and its characteristics are unclear. Approach and results This cross-sectional study included adults and AYA aged 20–79 and 12–19 years, respectively, from the National Health and Nutrition Examination Survey from 1999 to 2018. MASLD was defined as US Fatty Liver Index ≥30 in adults and alanine amino transaminase elevation and obesity in AYA. Joinpoint and logistic regression were used to evaluate the MASLD prevalence trend and its associated characteristics. MASLD was diagnosed in 17 156 892 of 51 109 914 (33.6%) adults and 1 705 586 of 29 278 666 AYA (5.8%). During the study period, MASLD prevalence significantly increased from 30.8% to 37.7% (P < 0.01) in adults and in subgroups of female participants, individuals aged 20–45 and 61–79 years, and non-Hispanic white individuals. Conversely, MASLD prevalence did not significantly change in AYA (from 5.1% to 5.2%, P = 0.139), except in the subgroup of Mexican Americans (from 8.2% to 10.8%, P = 0.01). Among adults, high MASLD prevalence was associated with male sex, Mexican American ethnicity, age >50 years, being unmarried, poverty income ratio <130, poor or fair health condition, obesity or overweight, and chronic conditions. Among AYA, high MASLD prevalence was associated with male sex, poverty income ratio <130, and education. Conclusion Accordingly, we concluded that health care providers should prevent and treat conditions associated with MASLD by raising awareness of the increasing trend of MASLD.

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“…Additionally, patients with cirrhosis frequently have multiple chronic conditions,12–14 although their impact on prognosis remains unclear,14 and despite a distinction between comorbidity and multimorbidity has never been assessed. Besides its biological complexity, the impact of socioeconomic factors, that is, education, marital and employment status, household income, is an additional detrimental factor the effects of which appear to vary according to disease aetiology,15 16 and to have a relevant impact on survival and overall patients’ management 15 17. In particular, different networks and trajectories of disease association might be noticed according to the specific aetiology of cirrhosis, such as chronic viral hepatitis (hepatitis B virus (HBV), hepatitis C virus (HCV) related), alcoholic liver disease, autoimmune liver disease and non-alcoholic fatty liver disease (NAFLD) 18…”

Section: Introductionmentioning

confidence: 99%

Comorbidity and multimorbidity in patients with cirrhosis, hospitalised in an internal medicine ward: a monocentric, cross-sectional study

Lenti,

Ballesio,

Croce

et al. 2024

BMJ Open

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ObjectivesThere are no data regarding the prevalence of comorbidity (ie, additional conditions in reference to an index disease) and multimorbidity (ie, co-occurrence of multiple diseases in which no one holds priority) in patients with liver cirrhosis. We sought to determine the rate and differences between comorbidity and multimorbidity depending on the aetiology of cirrhosis.DesignThis is a subanalysis of the San MAtteo Complexity (SMAC) study. We have analysed demographic, clinical characteristics and rate of comorbidity/multimorbidity of patients with liver cirrhosis depending on the aetiology—alcoholic, infectious and non-alcoholic fatty liver disease (NAFLD). A multivariable analysis for factors associated with multimorbidity was fitted.SettingSingle-centre, cross-sectional study conducted in a tertiary referral, academic, internal medicine ward in northern Italy (November 2017–November 2019).ParticipantsData from 1433 patients previously enrolled in the SMAC study were assessed; only those with liver cirrhosis were eventually included.ResultsOf the 1433 patients, 172 (median age 79 years, IQR 67–84; 83 females) had liver cirrhosis. Patients with cirrhosis displayed higher median Cumulative Illness Rating Scale (CIRS) comorbidity (4, IQR 3–5; p=0.01) and severity (1.85, IQR 16.–2.0; p<0.001) indexes and lower educational level (103, 59.9%; p=0.003). Patients with alcohol cirrhosis were significantly younger (median 65 years, IQR 56–79) than patients with cirrhosis of other aetiologies (p<0.001) and more commonly males (25, 75.8%). Comorbidity was more prevalent in patients with alcohol cirrhosis (13, 39.4%) and multimorbidity was more prevalent in viral (64, 81.0%) and NAFLD (52, 86.7%) cirrhosis (p=0.015). In a multivariable model for factors associated with multimorbidity, a CIRS comorbidity index >3 (OR 2.81, 95% CI 1.14 to 6.93, p=0.024) and admission related to cirrhosis (OR 0.19, 95% CI 0.07 to 0.54, p=0.002) were the only significant associations.ConclusionsComorbidity is more common in alcohol cirrhosis compared with other aetiologies in a hospital, internal medicine setting.

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Influence of socioeconomic and cultural factors in the etiology of cirrhosis of the liver

Cited by 4 publications

References 28 publications

Non-alcoholic fatty liver disease and socioeconomic determinants in an Iranian cohort study

Non-alcoholic fatty liver disease and socioeconomic determinants in an Iranian cohort study

Prevalence, trends, and characteristics of metabolic dysfunction-associated steatotic liver disease among the US population aged 12–79 years

Comorbidity and multimorbidity in patients with cirrhosis, hospitalised in an internal medicine ward: a monocentric, cross-sectional study

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