title: Prevalence and associated factors with esophageal varices in early primary biliary cirrhosis.
abstract: OBJECTIVE
  Recent routine testing for anti-mitochondrial antibodies has increased the number of patients with early primary biliary cirrhosis (PBC). The prevalence and clinical significance of esophageal varices in those patients remains obscure.
  
  
  METHODS
  A systematic cohort analysis of 256 PBC patients was performed to clarify the prevalence, characteristics, and prognosis of the patients with early PBC and esophageal varices.
  
  
  RESULTS
  Twenty-two patients had esophageal varices at the time of diagnosis: 5.5% (12/217) with early disease of histological stage 1 or 2, and 25.6% (10/39) with advanced disease of stage 3 or 4. Immediate treatments were required for two patients with early PBC: one for bleeding varices, and the other for large varices. The overall survival of the patients with early PBC and esophageal varices at diagnosis did not significantly differ from that of patients without esophageal varices (P = 0.66). High alkaline phosphatase (ALP) ratios (odds ratio = 2.3) and low platelet counts (odds ratio = 0.77) were significantly associated with the presence of esophageal varices in the patients with early PBC. Significant associations of these two factors with the development of esophageal varices during follow-up were also revealed (odds ratio = 1.4 and 0.88, respectively). The patients with early PBC and high ALP ratios ≥ 1.9 had significantly high risks of developing esophageal varices during follow-up (P = 0.022).
  
  
  CONCLUSIONS
  High ALP ratios and low platelet counts at diagnosis and decreased platelet counts during follow-up are useful predictors of esophageal varices in patients with early PBC.
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. fikeda@md.okayama-u.ac.jp
authors.forename: Fusao
authors.initials: F
authors.lastname: Ikeda
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Okamoto
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Baba
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Fujioka
authors.forename: Bon
authors.initials: B
authors.lastname: Shoji
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Yabushita
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ando
authors.forename: Shuji
authors.initials: S
authors.lastname: Matsumura
authors.forename: Junichi
authors.initials: J
authors.lastname: Kubota
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yasunaka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyake
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kobashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D042241:Early Diagnosis; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010976:Platelet Count; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D000469:Alkaline Phosphatase