title: Non-alcoholic steatohepatitis-related liver cirrhosis is increasing in China: a ten-year retrospective study.
abstract: OBJECTIVE
  Little is known about metabolic factors in cirrhotic patients in China. Therefore, we aimed to quantify the prevalence of both metabolic factors and non-alcoholic steatohepatitis-related liver cirrhosis in China.
  
  
  METHODS
  The medical records of 1,582 patients diagnosed with liver cirrhosis from June 2003 to July 2013 at Daping Hospital (Chongqing, China) were retrospectively reviewed through a computer-generated search.
  
  
  RESULTS
  Serum hepatitis B virus surface antigen was present in 1,083 (68.5%) patients, and hepatitis B was found to be the only etiological factor in 938 (59.3%) of all patients. Obesity, diabetes mellitus, and arterial hypertension were observed in 229 (14.5%), 159 (10.1%), and 129 (8.2%) patients, respectively. From 2012-2013, the proportion of non-alcoholic steatohepatitis-related liver cirrhosis increased to 3.2%, whereas the average proportion of non-alcoholic steatohepatitis-related liver cirrhosis in the previous ten years was 1.9%. The incidence of hepatocellular carcinoma was much higher in males than in females (6.3% vs. 3.7%, respectively, p=0.036). Obesity and diabetes mellitus did not significantly increase the incidence of hepatocellular carcinoma in the whole cirrhotic group. The presence of hepatitis B virus was the only risk factor for hepatocellular carcinoma in cirrhotic patients (p<0.001).
  
  
  CONCLUSIONS
  Although hepatitis B virus remains the main etiology of liver cirrhosis in China, steatohepatitis-related liver cirrhosis is increasing in frequency. Hepatitis B virus was the sole significant risk factor for hepatocellular carcinoma in the whole cirrhotic group in the present study, in contrast to obesity and diabetes mellitus, for which only a trend of increased hepatocellular carcinoma was found.
authors.affiliation: Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Xiong
authors.affiliation: Chinese People's Armed Police Force, Xinjiang, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Huang
authors.affiliation: Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Sun
authors.affiliation: Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000378:metabolism; D002681:China / Q000453:epidemiology; D048909:Diabetes Complications / Q000378:metabolism; D004812:Epidemiologic Methods; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006515:Hepatitis B virus / Q000472:pathogenicity; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D008113:Liver Neoplasms / Q000209:etiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D009765:Obesity / Q000150:complications / Q000378:metabolism; D012737:Sex Factors; D013997:Time Factors