Horie Yoshinori, Yamagishi Yoshiyuki, Ebinuma Hirotoshi, Hibi Toshifumi
International University of Health and Welfare Research Centre of Clinical Medicine, Sanno Hospital, 8-10-16 Akasaka Minato-ku, Tokyo, 107-0052, Japan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University, Tokyo, Japan.
Hepatol Int. 2013 Mar;7(1):280-5. doi: 10.1007/s12072-012-9347-6. Epub 2012 Feb 9.
Recent epidemiological studies show that alcoholic liver cirrhosis (ALC) continues to increase in spite of a gradual decrease in the alcohol intake beyond 1999, indicating that there are other risk factors for the development of ALC.
A nationwide survey of liver cirrhosis (LC) was undertaken by asking major hospital institutions to provide the number of patients with LC admitted between 2007 and 2008 together with their etiologic findings including the daily intake of alcohol, period of drinking, and other relevant demographic measurements.
The intake of alcohol in female ALC patients was lower together with a shorter drinking period versus male patients. The prevalence of diabetes mellitus (DM) in ALC patients was higher in habitual drinkers (<110 g/day) than in heavy drinkers (≥110 g/day), 49.5 versus 20.3%, respectively (P < 0.001). In male ALC patients, the prevalence of DM was higher in habitual drinkers, 55.2 versus 20.6% for the female gender (P < 0.001). The same tendency was seen in patients with a body mass index ≥25. The prevalence of obesity was higher in habitual drinkers than in heavy drinkers, 49.7 versus 31.1%, respectively. More than 90% of the male habitual drinkers either had DM or were obese, whereas less than half of the female habitual drinkers had a concomitant complication. More than 70% of the male ALC patients were over 60 years.
Obesity, DM, age, and female gender appear to be additional significant risk factors for ALC. Our impression is that these additional risk factors might help to identify alcoholic patients who may progress to ALC even without excessive alcohol intake.
近期的流行病学研究表明，尽管自1999年以来酒精摄入量逐渐下降，但酒精性肝硬化（ALC）的发病率仍持续上升，这表明存在其他导致ALC发生的风险因素。
通过要求各大医院机构提供2007年至2008年期间收治的肝硬化（LC）患者数量及其病因调查结果，包括每日酒精摄入量、饮酒时间以及其他相关人口统计学指标，开展了一项全国范围内的肝硬化调查。
与男性患者相比，女性ALC患者的酒精摄入量较低，饮酒时间也较短。在习惯性饮酒者（<110克/天）中，ALC患者的糖尿病（DM）患病率高于重度饮酒者（≥110克/天），分别为49.5%和20.3%（P<0.001）。在男性ALC患者中，习惯性饮酒者的DM患病率更高，女性为55.2%，而重度饮酒者为20.6%（P<0.001）。体重指数≥25的患者也呈现出相同趋势。习惯性饮酒者的肥胖患病率高于重度饮酒者，分别为49.7%和31.1%。超过90%的男性习惯性饮酒者患有DM或肥胖，而女性习惯性饮酒者中伴有并发症的不到一半。超过70%的男性ALC患者年龄超过60岁。
肥胖、DM、年龄和女性性别似乎是ALC的其他重要风险因素。我们的印象是，这些额外的风险因素可能有助于识别即使不过量饮酒也可能进展为ALC的酒精性患者。
