Mortality rate of patients with asymptomatic primary biliary cirrhosis diagnosed at age 55 years or older is similar to that of the general population.
OBJECTIVE
Recent routine testing for liver function and anti-mitochondrial antibodies has increased the number of newly diagnosed patients with primary biliary cirrhosis (PBC). This study investigated the prognosis of asymptomatic PBC patients, focusing on age difference, to clarify its effect on the prognosis of PBC patients.


METHODS
The study was a systematic cohort analysis of 308 consecutive patients diagnosed with asymptomatic PBC. We compared prognosis between the elderly (55 years or older at the time of diagnosis) and the young patients (<55 years). The mortality rate of the patients was also compared with that of an age- and gender-matched general population.


RESULTS
The elderly patients showed a higher aspartate aminotransferase-to-platelet ratio, and lower alanine aminotransferase level than the young patients (P < 0.01 and P = 0.03, respectively). The two groups showed similar values for alkaline phosphatase and immunoglobulin M. Death in the young patients was more likely to be due to liver failure (71%), while the elderly were likely to die from other causes before the occurrence of liver failure (88%; P < 0.01), especially from malignancies (35%). The mortality rate of the elderly patients was not different from that of the age- and gender-matched general population (standardized mortality ratio, 1.1; 95% confidence interval, 0.6-1.7), although this rate was significantly higher than that of the young patients (P = 0.044).


CONCLUSIONS
PBC often presents as more advanced disease in elderly patients than in the young. However, the mortality rate of the elderly patients is not different from that of an age- and gender-matched general population.
Kubota
Junichi
J
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama, 700-8558, Japan.
Ikeda
Fusao
F
Terada
Ryo
R
Kobashi
Haruhiko
H
Fujioka
Shin-ichi
S
Okamoto
Ryoichi
R
Baba
Shinsuke
S
Morimoto
Youichi
Y
Ando
Masaharu
M
Makino
Yasuhiro
Y
Taniguchi
Hideaki
H
Yasunaka
Tetsuya
T
Miyake
Yasuhiro
Y
Iwasaki
Yoshiaki
Y
Yamamoto
Kazuhide
K
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000378:metabolism*; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D017093:Liver Failure / Q000209:etiology / Q000401:mortality*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012737:Sex Factors; D055815:Young Adult
D007075:Immunoglobulin M