Tags

Type your tag names separated by a space and hit enter

Clinical features and outcomes of cirrhosis due to non-alcoholic steatohepatitis compared with cirrhosis caused by chronic hepatitis C.

Abstract

BACKGROUND AND AIM

Ethnic differences in non-alcoholic steatohepatitis (NASH) are well-documented, but there has been no study on the prognosis of Japanese NASH patients with cirrhosis. Accordingly, we compared cirrhotic NASH with liver cirrhosis caused by chronic hepatitis C (LC-C) to clarify its clinical features and define the risk factors for death.

METHODS

A prospective evaluation of the outcomes of NASH patients with severe fibrosis was started in 1990. Data on age- and sex-matched patients with biopsy-proven LC-C were collected retrospectively and used as the control.

RESULTS

There were 68 patients with cirrhotic NASH and 69 with LC-C. The Child-Turcotte-Pugh (CTP) class was similar in these two groups. Although the outcome of the NASH group was better than that of the LC-C group, cirrhotic NASH followed a similar course to that of LC-C; that is, complications of cirrhosis developed, including hepatocellular carcinoma (HCC; the 5-year HCC rate was 11.3% for NASH and 30.5% for HCV) and death (the 5-year survival rates were 75.2% and 73.8%, respectively). HCC was the leading cause of death in both groups (NASH, 47%; HCV, 68%). The occurrence of HCC and the CTP class were significant risk factors for mortality in NASH patients according to a multivariate analysis (HCC: hazard ratio [HR] 7.96, 95% confidence interval [CI] 2.45-25.88, CTP class A: HR 0.17, 95% CI 0.06-0.50).

CONCLUSION

In conclusion, the present study confirmed that cirrhotic NASH has a similar course to LC-C. The occurrence of HCC was the strongest predictor of mortality in the NASH groups. These findings may be helpful when deciding on therapeutic interventions for NASH and also for the daily management of these patients.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Internal Medicine and Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.

    , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Asian Continental Ancestry Group
    Biopsy
    Carcinoma, Hepatocellular
    Case-Control Studies
    Disease Progression
    Fatty Liver
    Female
    Hepatitis C, Chronic
    Humans
    Japan
    Kaplan-Meier Estimate
    Liver
    Liver Cirrhosis
    Liver Neoplasms
    Male
    Middle Aged
    Proportional Hazards Models
    Prospective Studies
    Retrospective Studies
    Risk Assessment
    Risk Factors
    Severity of Illness Index
    Time Factors
    Treatment Outcome
    Young Adult

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    19032450

    Citation

    Yatsuji, Satoru, et al. "Clinical Features and Outcomes of Cirrhosis Due to Non-alcoholic Steatohepatitis Compared With Cirrhosis Caused By Chronic Hepatitis C." Journal of Gastroenterology and Hepatology, vol. 24, no. 2, 2009, pp. 248-54.
    Yatsuji S, Hashimoto E, Tobari M, et al. Clinical features and outcomes of cirrhosis due to non-alcoholic steatohepatitis compared with cirrhosis caused by chronic hepatitis C. J Gastroenterol Hepatol. 2009;24(2):248-54.
    Yatsuji, S., Hashimoto, E., Tobari, M., Taniai, M., Tokushige, K., & Shiratori, K. (2009). Clinical features and outcomes of cirrhosis due to non-alcoholic steatohepatitis compared with cirrhosis caused by chronic hepatitis C. Journal of Gastroenterology and Hepatology, 24(2), pp. 248-54. doi:10.1111/j.1440-1746.2008.05640.x.
    Yatsuji S, et al. Clinical Features and Outcomes of Cirrhosis Due to Non-alcoholic Steatohepatitis Compared With Cirrhosis Caused By Chronic Hepatitis C. J Gastroenterol Hepatol. 2009;24(2):248-54. PubMed PMID: 19032450.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinical features and outcomes of cirrhosis due to non-alcoholic steatohepatitis compared with cirrhosis caused by chronic hepatitis C. AU - Yatsuji,Satoru, AU - Hashimoto,Etsuko, AU - Tobari,Maki, AU - Taniai,Makiko, AU - Tokushige,Katsutoshi, AU - Shiratori,Keiko, Y1 - 2008/11/20/ PY - 2008/11/27/pubmed PY - 2009/5/8/medline PY - 2008/11/27/entrez SP - 248 EP - 54 JF - Journal of gastroenterology and hepatology JO - J. Gastroenterol. Hepatol. VL - 24 IS - 2 N2 - BACKGROUND AND AIM: Ethnic differences in non-alcoholic steatohepatitis (NASH) are well-documented, but there has been no study on the prognosis of Japanese NASH patients with cirrhosis. Accordingly, we compared cirrhotic NASH with liver cirrhosis caused by chronic hepatitis C (LC-C) to clarify its clinical features and define the risk factors for death. METHODS: A prospective evaluation of the outcomes of NASH patients with severe fibrosis was started in 1990. Data on age- and sex-matched patients with biopsy-proven LC-C were collected retrospectively and used as the control. RESULTS: There were 68 patients with cirrhotic NASH and 69 with LC-C. The Child-Turcotte-Pugh (CTP) class was similar in these two groups. Although the outcome of the NASH group was better than that of the LC-C group, cirrhotic NASH followed a similar course to that of LC-C; that is, complications of cirrhosis developed, including hepatocellular carcinoma (HCC; the 5-year HCC rate was 11.3% for NASH and 30.5% for HCV) and death (the 5-year survival rates were 75.2% and 73.8%, respectively). HCC was the leading cause of death in both groups (NASH, 47%; HCV, 68%). The occurrence of HCC and the CTP class were significant risk factors for mortality in NASH patients according to a multivariate analysis (HCC: hazard ratio [HR] 7.96, 95% confidence interval [CI] 2.45-25.88, CTP class A: HR 0.17, 95% CI 0.06-0.50). CONCLUSION: In conclusion, the present study confirmed that cirrhotic NASH has a similar course to LC-C. The occurrence of HCC was the strongest predictor of mortality in the NASH groups. These findings may be helpful when deciding on therapeutic interventions for NASH and also for the daily management of these patients. SN - 1440-1746 UR - https://www.unboundmedicine.com/medline/citation/19032450/Clinical_features_and_outcomes_of_cirrhosis_due_to_non_alcoholic_steatohepatitis_compared_with_cirrhosis_caused_by_chronic_hepatitis_C_ L2 - https://doi.org/10.1111/j.1440-1746.2008.05640.x DB - PRIME DP - Unbound Medicine ER -