title: Impact of family history of metabolic traits on severity of non-alcoholic steatohepatitis related cirrhosis: A cross-sectional study.
abstract: Familial aggregation of metabolic traits with fatty liver disease is well documented. However, there is scarcity of data regarding such association with non-alcoholic steatohepatitis (NASH)-related cirrhosis. This study was aimed to explore the association of family history of metabolic traits with severity of cirrhosis.
  
  
  
  In a cross-sectional study, all consecutive patients with NASH-related cirrhosis presenting to our tertiary care centre were included. Family history, personal history, demographic characteristics, medical history, anthropometric measurements and laboratory data were recorded.
  
  
  
  Of the 1133 cirrhotics (68.1% males, age 51.4±10.9 years); 779 (68.8%) had family history for metabolic traits. These patients had lower age at diagnosis (45.4±10.6 vs 49.6±11.2 years), higher Child-Turcotte-Pugh (CTP) score (7.8±1.9 vs 6.6±1.5), higher model for end stage liver disease (MELD) score (12.9±6.1 vs 10.9±4.1) and more incidence of decompensation in the form of ascites (46.3% vs 25.7%), jaundice (12.1% vs 6.2%) and hepatic encephalopathy (26.1% vs 11.0%). Patients with family and personal history of metabolic traits, had an increased risk of an early diagnosis of cirrhosis at<45 years of age (OR: 3.1, 95% CI 2.1-4.4), CTP≥10 (OR: 4.6, 95% CI 2.3-9.1), MELD>15 (OR: 6.6, 95% CI 3.8-11.5) with ≥1 features of decompensation (OR: 4.2, 95% CI 2.9-6.1). Family history of diabetes alone, also had higher risk of cirrhosis with MELD>15 (OR: 4.3, 95% CI 2.4-5.3, P<.001).
  
  
  
  Family and personal history of metabolic traits are associated with early age at diagnosis of cirrhosis with more severity and decompensation and so, has a prognostic importance in NASH-related cirrhotics.
authors.affiliation: Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Ajeet S
authors.initials: AS
authors.lastname: Bhadoria
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Chandan K
authors.initials: CK
authors.lastname: Kedarisetty
authors.affiliation: Department of Pathology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Chhagan
authors.initials: C
authors.lastname: Bihari
authors.affiliation: Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Guresh
authors.initials: G
authors.lastname: Kumar
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Ankur
authors.initials: A
authors.lastname: Jindal
authors.affiliation: Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Ankit
authors.initials: A
authors.lastname: Bhardwaj
authors.affiliation: Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Varsha
authors.initials: V
authors.lastname: Shasthry
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Tanmay
authors.initials: T
authors.lastname: Vyas
authors.affiliation: Department of Clinical Nutrition, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Jaya
authors.initials: J
authors.lastname: Benjamin
authors.affiliation: Department of Molecular and cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Shvetank
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Manoj K
authors.initials: MK
authors.lastname: Sharma
authors.affiliation: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Shiv K
authors.identifier: 0000-0002-0544-5610
authors.initials: SK
authors.lastname: Sarin
mesh_terms: D000328:Adult; D001201:Ascites / Q000209:etiology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006501:Hepatic Encephalopathy / Q000150:complications; D006801:Humans; D007194:India; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D016015:Logistic Models; D008297:Male; D008487:Medical History Taking; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D010375:Pedigree; D011379:Prognosis; D012720:Severity of Illness Index; D062606:Tertiary Care Centers
keywords: chronic liver disease; fatty liver; fibrosis; liver transplant; non-alcoholic steatohepatitis; portal hypertension