title: Liver cirrhosis in Malaysia: peculiar epidemiology in a multiracial Asian country.
abstract: OBJECTIVE
  To determine the etiology of liver cirrhosis and risk factors for hepatocellular carcinoma (HCC) in a multiracial Asian population.
  
  
  METHODS
  Consecutive patients with liver cirrhosis presenting to outpatient clinics and inpatient service at the University of Malaya Medical Centre from 1 April 2006 to 31 May 2009 were included.
  
  
  RESULTS
  A total of 460 patients were included in the study: 317 male patients (68.9%) and 143 female patients (31.1%), with a mean age of 58.8years (range: 15-87years). The major causes of cirrhosis were: chronic hepatitis B, n=212, 46.1%; chronic hepatitis C, n=85, 18.5%; cryptogenic, n=71, 15.4%; alcohol, n=58, 12.6% and autoimmune, n=9, 2.0%. Alcohol was the main etiology in Indians (51.1%) compared to Malay (0%) and Chinese (4.4%) (both P<0.001). Hepatitis B was the predominant etiology in Malay (47.9%) and Chinese (58.8%) compared to Indians (5.6%) (both P<0.001). Hepatitis C cirrhosis was highest in Malays (25.0%). 136 patients (29.6%) had concurrent HCC. Male sex (P<0.001), age>60years (P=0.014), hepatitis B (P<0.001), hepatitis C (P=0.006) and cryptogenic cause (P=0.002) were found to be independent risk factors for HCC.
  
  
  CONCLUSIONS
  The etiology of cirrhosis has a peculiar pattern based on racial differences in alcohol intake and in the prevalence of hepatitis B.
authors: Division of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia.
authors: Choon-Seng
authors: CS
authors: Qua
authors: Khean-Lee
authors: KL
authors: Goh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000208:ethnology; D044466:Asian People / Q000706:statistics & numerical data*; D006528:Carcinoma, Hepatocellular / Q000208:ethnology*; D016009:Chi-Square Distribution; D002681:China / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D019694:Hepatitis B, Chronic / Q000208:ethnology; D019698:Hepatitis C, Chronic / Q000208:ethnology; D006801:Humans; D007194:India / Q000208:ethnology; D008103:Liver Cirrhosis / Q000208:ethnology*; D008113:Liver Neoplasms / Q000208:ethnology*; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult