Rising cirrhosis incidence and mortality in the United Kingdom has been attributed predominantly to excess alcohol consumption.
However, metabolic risk factors such as Type 2 diabetes and obesity may also be important.
Dr Guha and colleagues from the United Kingdom screened at-risk individuals in general practice for undetected cirrhosis using transient elastography and study the risk factors underlying these cases.
The research team evaluated 4 general practices between 2012 and 2014.
Patients with defined risk factors for chronic liver disease were identified from the General Practice electronic records and invited for transient elastography.
Elevated liver stiffness was defined as ≥8 kPa.
|25% had elevated liver stiffness|
|Alimentary Pharmacology & Therapeutics|
Cirrhosis was confirmed by established histological, radiological and biochemical methods.
The researchers invited 2368 patients for transient elastography, and 98% had valid measurements.
Of these 230 patients, 25% had elevated liver stiffness, 3% had cirrhosis.
The researchers noted that risk factors for new cirrhosis diagnoses were obesity and/or Type 2 diabetes in 59% of patients, alcohol alone in 11%, and both alcohol and obesity and/or diabetes in 30%.
Presence of cirrhosis was significantly increased in obese patients with Type 2 diabetes or hazardous alcohol use compared to non-obese.
Dr Guha's team concluded, "The number of new cases of cirrhosis diagnosed clearly demonstrates that existing estimates of prevalence are likely to be gross underestimates."
"Obesity was an important risk factor for cirrhosis within both alcohol users and diabetics."