Liver international : official journal of the International Association for the Study of the Liver 2017 02 23() doi 10.1111/liv.13396
BACKGROUND AND AIMS
Familial aggregation of metabolic traits with fatty liver disease is well documented. However, there is scarcity of data regarding such association with non-alcoholic steato-hepatitis (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 1,133 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±11.2yr), higher CTP score (7.8±1.9 vs. 6.6±1.5), higher 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 yrs 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<0.001). CONCLUSION
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. This article is protected by copyright. All rights reserved.