Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden.
Department of Internal Medicine, Halland Hospital Halmstad, Halmstad, Sweden.
BMC Gastroenterol. 2020 Apr 3;20(1):84. doi: 10.1186/s12876-020-01239-6.
The incidence of cirrhosis for individuals in Sweden has previously been reported as stable/low among European countries. However, Swedish population-based studies are scarce and none of them included data from the most recent decade (2010-2019). We aimed to describe the incidence and aetiology of cirrhosis in the Halland region from 2011 to 2018, and to describe the severity and prevalence of liver-related complications and other primary comorbidities at the time of cirrhosis diagnosis.
We conducted a retrospective cohort study of all patients with cirrhosis in Halland, which has a population of 310,000 inhabitants. Medical records and histopathology registries were reviewed.
A total of 598 patients with cirrhosis were identified. The age-standardised incidence was estimated at 23.2 per 100,000 person-years (95% CI 21.3-25.1), 30.5 (95% CI 27.5-33.8) for men and 16.4 (95% CI 14.3-18.7) for women. When stratified by age, the highest incidence rates were registered at age 60-69 years. Men had a higher incidence rate for most age groups when compared to women. The most common aetiology was alcohol (50.5%), followed by cryptogenic cirrhosis (14.5%), hepatitis C (13.4%), and non-alcoholic fatty liver disease (5.7%). Most patients had at least one liver-related complication at diagnosis (68%). The most common comorbidities at diagnosis were arterial hypertension (33%), type 2 diabetes (29%) and obesity (24%).
Based on previous Swedish studies, our results indicate that the incidence of cirrhosis in Sweden might be considerably higher than previously reported. It is uncertain if the incidence of cirrhosis has previously been underestimated or if an actual increment has occurred during the course of the most recent decade. The increased incidence rates of cirrhosis reported in Halland are multifactorial and most likely related to higher incidence rates among the elderly. Pre-obesity and obesity are common in cirrhosis and non-alcoholic fatty liver disease has become an important cause of cirrhosis in Halland.
瑞典的个体肝硬化发病率在欧洲国家中一直被报告为稳定/较低。然而，瑞典的基于人群的研究很少，且没有一个研究包含最近十年（2010-2019 年）的数据。我们旨在描述 2011 年至 2018 年期间 Halland 地区肝硬化的发病率和病因，并描述肝硬化诊断时肝相关并发症和其他主要合并症的严重程度和患病率。
我们对 Halland 地区的所有肝硬化患者进行了回顾性队列研究，该地区人口为 31 万。审查了医疗记录和组织病理学登记处。
共确定了 598 例肝硬化患者。年龄标准化发病率估计为每 100,000 人年 23.2 例（95%CI 21.3-25.1），男性为 30.5（95%CI 27.5-33.8），女性为 16.4（95%CI 14.3-18.7）。按年龄分层时，60-69 岁年龄组的发病率最高。与女性相比，男性在大多数年龄组中的发病率更高。最常见的病因是酒精（50.5%），其次是隐源性肝硬化（14.5%）、丙型肝炎（13.4%）和非酒精性脂肪性肝病（5.7%）。大多数患者在诊断时至少有一种肝相关并发症（68%）。诊断时最常见的合并症是动脉高血压（33%）、2 型糖尿病（29%）和肥胖症（24%）。
基于以前的瑞典研究，我们的结果表明，瑞典的肝硬化发病率可能远高于以前报告的水平。目前还不确定肝硬化的发病率以前是否被低估，或者在最近十年期间是否确实有所增加。Halland 报告的肝硬化发病率增加是多因素的，很可能与老年人的发病率增加有关。肥胖前期和肥胖症在肝硬化中很常见，非酒精性脂肪性肝病已成为 Halland 肝硬化的重要病因。
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