Transition in the etiology of liver cirrhosis in Japan: a nationwide survey
Transition in the etiology of liver cirrhosis in Japan: a nationwide survey
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DOI：
10.1007/s00535-019-01645-y
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发表时间：
2020-03-01
影响因子：
6.3
通讯作者：
Nishiguchi, Shuhei
中科院分区：
文献类型：
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作者：
Enomoto, Hirayuki;Ueno, Yoshiyuki;Nishiguchi, Shuhei
为了评估日本肝硬化（LC）病因学的最新变化，我们在日本肝病学会（JSH）年会上进行了一项全国性调查。方法对79家医疗机构（N = 48，621）68例LC患者的病因进行调查。我们接下来通过分析诊断年份可用的病例（N = 45，834）来评估LC病因的变化趋势。我们通过评估2008-2016年36家医院的完整数据集（N = 18，358），进一步评估了新识别LC患者的真实的数量的变化。结果在日本，HCV感染（48.2%）是LC的第一位病因，HBV感染（11.5%）是第三位病因。关于LC病因的转变，病毒性肝炎相关LC的贡献从73.4%降至49.7%。在非病毒病因中，酒精相关疾病（ALD）和非酒精性脂肪性肝炎（NASH）相关LC显示出显著增加（分别从13.7%增加至24.9%和从2.0%增加至9.1%）。从2008年至2016年新诊断的真实的患者数量来看，病毒性肝炎相关LC患者数量减少，而非病毒性LC患者数量增加。结论在日本，HCV仍是LC的主要病因，但病毒性肝炎作为LC病因的贡献正在下降。此外，在日本，非病毒性LC（如ALD相关LC和NASH相关LC）作为LC的病因也有所增加。
Background To assess the recent real-world changes in the etiologies of liver cirrhosis (LC) in Japan, we conducted a nationwide survey in the annual meeting of the Japan Society of Hepatology (JSH). Methods We investigated the etiologies of LC patients accumulated from 68 participants in 79 institutions (N = 48,621). We next assessed changing trends in the etiologies of LC by analyzing cases in which the year of diagnosis was available (N = 45,834). We further evaluated the transition in the real number of newly identified LC patients by assessing data from 36 hospitals with complete datasets for 2008-2016 (N = 18,358). Results In the overall data, HCV infection (48.2%) was the leading cause of LC in Japan, and HBV infection (11.5%) was the third-most common cause. Regarding the transition in the etiologies of LC, the contribution of viral hepatitis-related LC dropped from 73.4 to 49.7%. Among the non-viral etiologies, alcoholic-related disease (ALD) and nonalcoholic steatohepatitis (NASH)-related LC showed a notable increase (from 13.7 to 24.9% and from 2.0 to 9.1%, respectively). Regarding the real numbers of newly diagnosed patients from 2008 to 2016, the numbers of patients with viral hepatitis-related LC decreased, while the numbers of patients with non-viral LC increased. Conclusions HCV has remained the main cause of LC in Japan; however, the contribution of viral hepatitis as an etiology of LC is suggested to have been decreasing. In addition, non-viral LC, such as ALD-related LC and NASH-related LC, is suggested to have increased as etiologies of LC in Japan.