title: Behaviour does not fully explain the high risk of chronic liver disease in less educated men in Hungary.
abstract: BACKGROUND
  Hungary has among the highest mortality rates from chronic liver disease (CLD) and cirrhosis in Europe. Usually, conventional behavioural factors are hypothesized as the cause of the high risk of CLD.
  
  
  METHODS
  A case-control study was performed with 287 cases and 892 controls to study the relationship between socio-economic and behavioural factors and the risk of CLD. Liver disease was verified by physical examination and blood tests. Blood samples were collected for detecting hepatitis B, C and E virus infection. Information on exposure factors was recorded by the participating physicians and by self-administered questionnaire. Simple regression analysis was used to study the relationship between CLD/cirrhosis and potential risk factors as alcohol intake (amount and source), problem drinking, cigarette smoking, physical activity, viral hepatitis infections, socio-economic factors (education, financial and marital status). Multiple regression analysis was used to identify whether the effect of socio-economic factors is fully mediated by health behaviour (smoking, alcohol consumption, physical activity).
  
  
  RESULTS
  The univariate analysis showed that heavy alcohol consumption, problem drinking, former and heavy cigarette smoking, single, separated or divorced marital status, bad or very bad perceived financial status and lower education significantly increased the risk of CLD/cirrhosis. The effect of marital status and of education did not change after adjustment for behavioural factors, but the effect of perceived financial status disappeared.
  
  
  CONCLUSIONS
  The effect of low socio-economic status on the risk of CLD/cirrhosis is only partially explained by conventional behavioural risk factors in Hungary.
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, Medical & Health Science Centre, University of Debrecen, Kassai út 26/b, Debrecen, Hungary, H-4012.
authors.forename: Beáta É
authors.initials: BÉ
authors.lastname: Petrovski
authors.forename: György
authors.initials: G
authors.lastname: Széles
authors.forename: Márta
authors.initials: M
authors.lastname: Melles
authors.forename: Vera
authors.initials: V
authors.lastname: Pataki
authors.forename: László
authors.initials: L
authors.lastname: Kardos
authors.forename: Tibor
authors.initials: T
authors.lastname: Jenei
authors.forename: Róza
authors.initials: R
authors.lastname: Ádány
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Vokó
mesh_terms: D000428:Alcohol Drinking; D016022:Case-Control Studies; D002908:Chronic Disease; D004522:Educational Status; D015444:Exercise; D015438:Health Behavior; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology; D016751:Hepatitis E / Q000150:complications / Q000453:epidemiology; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology; D008107:Liver Diseases / Q000150:complications / Q000453:epidemiology*; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires