PREVALENCE OF CHRONIC LIVER-DISEASE IN THE GENERAL-POPULATION OF NORTHERN ITALY - THE DIONYSOS STUDY
PREVALENCE OF CHRONIC LIVER-DISEASE IN THE GENERAL-POPULATION OF NORTHERN ITALY - THE DIONYSOS STUDY
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DOI：
10.1002/hep.1840200611
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发表时间：
1994-12-01
期刊：
影响因子：
13.5
通讯作者：
SASSATELLI, R
中科院分区：
文献类型：
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作者：
BELLENTANI, S;TIRIBELLI, C;SASSATELLI, R
从选定的住院患者系列或死亡登记处得出的慢性肝病患病率数据低估了慢性肝病的患病率。狄俄尼索斯研究是一项队列研究，首次调查了普通人群中慢性肝病的患病率。意大利北部坎波加利亚诺和科尔蒙斯两个城镇的所有12至65岁的居民都收到了信函联系。从1991年3月到1993年3月，在总共10150名居民中，有6917人登记入组（依从性为69%）。针对每位入组者的标准化方案包括：(a)一份关于饮食习惯和酒精摄入的彩色图示食物问卷；(b)详细的病史，包括有关慢性肝病危险因素的问题；(c)身体检查；以及(d)天冬氨酸转氨酶、丙氨酸转氨酶、γ - 谷氨酰转肽酶、平均细胞体积、血小板计数以及乙肝病毒和丙肝病毒标志物的血液检测。21.3%的受试者出现了提示慢性肝病的体征，然后他们接受了进一步的肝功能检测、上腹部超声检查，必要时还进行了肝活检。17.5%的受试者存在慢性肝病的持续体征，其中包括1.1%的肝硬化患者和0.07%的肝细胞癌患者。乙肝病毒和丙肝病毒阳性率（第二代酶联免疫吸附试验）分别为1.3%和3.2%。酗酒是23%病例的病因。导致受试者易患慢性肝病的其他因素包括年龄超过35岁、男性、体重指数高于27、有输血史、吸毒成瘾以及受试者家庭中有慢性肝病患者。肝硬化由乙肝病毒或丙肝病毒引起的占37%，由酒精引起的占26%。在那些酗酒的受试者中，病毒感染，尤其是丙肝病毒，在慢性肝病的恶化及其进展为肝细胞癌的过程中起着重要作用。我们得出结论，狄俄尼索斯研究是对意大利北部普通人群中慢性肝病患病率的首次研究，发现慢性肝病的患病率比之前西方国家选定人群中所报告的要高得多。肝炎病毒感染和酗酒是最重要的病因。
Data on the prevalence of chronic liver disease, derived from selected series of hospitalized patients or from mortality registers, underestimate the prevalence of chronic liver disease. The Dionysos Study is a cohort study that investigated for the first time the prevalence of chronic liver disease in a general population. All the citizens of two towns in northern Italy, Campogalliano and Cormons, aged 12 to 65 yr were contacted by letter. From March 1991 through March 1993, 6,917 of a total of 10,150 citizens were enrolled (compliance, 69%). The standardized protocol for each enrollee included (a) a color-illustrated food questionnaire on dietary habits and alcohol intake; (b) a detailed medical history, including questions on risk factors for chronic Liver disease; (c) a physical examination; and (d) blood tests for AST, ALT, gamma-glutamyltranspeptidase, mean cell volume, platelet count and hepatitis B virus and hepatitis C virus markers. Signs suggestive of chronic Liver disease were seen in 21.3% of the subjects, and who then underwent further liver function tests, upper abdominal ultrasonography and, when necessary, liver biopsy. Persistent signs of chronic li ver disease were present in 17.5% of the subjects, including 1.1% with cirrhosis and 0.07% with hepatocellular carcinoma. The prevalence rates of hepatitis B virus and hepatitis C virus positivity (second-generation enzyme-linked immunosorbent assay) were 1.3% and 3.2%, respectively. Alcohol abuse was the etiological agent in 23%. Other factors which predisposed subjects to chronic liver disease were age older than 35 yr, male sex, body mass index higher than 27, history of blood transfusion, drug addiction and presence of chronic liver disease in the subject's family. Cirrhosis was due to hepatitis B virus or hepatitis C virus in 37%, and alcohol was the cause in 26%. In those subjects with alcohol abuse, viral infection, especially hepatitis C virus, played an important role in the deterioration of chronic liver disease and its progression to hepatocellular carcinoma. We conclude that the Dionysos study, the first study of the prevalence of chronic liver disease in a general population of northern Italy, found a much higher prevalence of chronic liver disease than reported previously in selected populations from Western countries. Hepatitis viral infections and alcoholism were the most important causative agents.