Smoking and increased severity of hepatic fibrosis in primary biliary cirrhosis: A cross validated retrospective assessment
Smoking and increased severity of hepatic fibrosis in primary biliary cirrhosis: A cross validated retrospective assessment
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DOI：
10.1002/hep.21423
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发表时间：
2006-12-01
期刊：
影响因子：
13.5
通讯作者：
McCullough, Arthur J.
中科院分区：
文献类型：
--
作者：
Zein, Claudia O.;Beatty, Kristi;McCullough, Arthur J.
吸烟与原发性胆汁性肝硬化（PBC）之间的流行病学联系已被证实。我们的目的是确定吸烟与PBC患者肝纤维化严重程度之间的关系。1998年10月至2005年12月期间在凯斯西储大学三家主要教学医院就诊的所有PBC患者均已确定。收集了97例患者首次评估时获得的PBC诊断数据。计算了每年吸烟的累计香烟包数（包-年）。晚期组织学疾病定义为Ludwig 3或4期。进行分析以确定晚期组织学疾病、吸烟和其他与肝纤维化相关的变量之间的关联。与早期疾病患者相比，晚期组织学疾病患者的吸烟史更常见（P = 0.0008）。在吸烟者中，晚期组织学疾病患者（30包-年）的平均终生烟草消费量高于早期疾病患者（17包-年）（P =.04）。Logistic回归分析表明，一生中吸烟≥ 10包年与晚期组织学疾病之间存在显著相关性（OR = 13.3）。在调整了年龄、性别和酒精摄入量后，这种关联仍然显着。这些结果的有效性得到了证实的交叉验证，在一个独立的验证集的172例PBC患者。结论：吸烟可加速PBC的进展。这可能是由于暴露于香烟烟雾中的化学物质引起的。
An epidemiological association between cigarette smoking and primary biliary cirrhosis (PBC) has been demonstrated. Our aim was to determine the relationship between smoking and severity of liver fibrosis at presentation in patients with PBC. All patients with PBC seen at the three major teaching hospitals of Case Western Reserve University between October 1998 and December 2005 were identified. Data obtained at the time of the first evaluation leading to the PBC diagnosis on 97 patients were collected. The cumulative number of cigarette packs smoked per year (pack-years) was calculated. Advanced histological disease was defined as Ludwig stages 3 or 4. Analyses were performed to determine associations between advanced histological disease, smoking and other variables related to liver fibrosis. Smoking history was more common (P = .0008) in patients with advanced histological disease at presentation compared to those with early disease. Among smokers, mean lifetime tobacco consumption was higher (P = .04) in cases with advanced histological disease at presentation (30 pack-years) compared to cases with early disease (17 pack-years). Logistic regression demonstrated a significant association between a lifetime tobacco consumption of >= 10 pack-years and advanced histological disease at presentation (OR = 13.3). The association remained significant after adjusting for age, gender, and alcohol intake. The validity of these results was corroborated by cross-validation in an independent confirmatory set of 172 patients with PBC. In conclusion, smoking may accelerate the progression of PBC. This could be induced by exposure to chemicals in cigarette smoke.