title: Risk factors of fibrosis in alcohol-induced liver disease.
abstract: In patients with nonalcoholic steatohepatitis (NASH), age, obesity, and diabetes mellitus are independent predictors of the degree of fibrosis. The relative risk for fibrosis adjusted for sex was also associated with increasing grade of Perls stain. The aim of this study was to determine whether the risk factors for fibrosis described in NASH are also risk factors in alcohol-induced liver disease. A total of 268 alcoholic patients with negative hepatitis B virus and hepatitis C virus serology underwent liver biopsy. Fibrosis was assessed semiquantitatively by a score fluctuating between 0 to 8. Liver iron overload was assessed by Perls staining and graded in 4 classes. We have used multivariate regression with partial correlation analysis to assess the variability of fibrosis score according to the value of 7 variables: sex, age, body mass index (BMI) in the past year before the hospitalization when the patient was asymptomatic, daily alcohol intake over the past 5 years, total duration of alcohol abuse, Perls grade, and blood glucose level. In the multivariate regression, fibrosis score was positively correlated with age (P =.001), BMI (P =.002), female sex (P <.05), Perls grade (P <.05), and blood glucose level (P <.05). Twenty percent of the variability of fibrosis score was explained by the 7 variables. In conclusion, after adjustment for daily alcohol intake and total duration of alcohol abuse, BMI, Perls grade, and blood glucose are also independent risk factors for fibrosis in alcohol-induced liver disease, raising therapeutic implications for the management of these patients.
authors.affiliation: Service d'Hépato-Gastroentérologie, Hôpital Antoine Béclère, 157 rue de la Porte de Trivaux, 92141 Clamart Cedex, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Raynard
authors.forename: Axel
authors.initials: A
authors.lastname: Balian
authors.forename: David
authors.initials: D
authors.lastname: Fallik
authors.forename: Frédérique
authors.initials: F
authors.lastname: Capron
authors.forename: Pierre
authors.initials: P
authors.lastname: Bedossa
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Chaput
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naveau
mesh_terms: D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D006801:Humans; D007501:Iron / Q000502:physiology; D008103:Liver Cirrhosis / Q000209:etiology*; D008108:Liver Diseases, Alcoholic / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D001786:Blood Glucose; D007501:Iron