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. 2002 Jun;35(6):1485-93.
doi: 10.1053/jhep.2002.33324.

Survival, liver failure, and hepatocellular carcinoma in obesity-related cryptogenic cirrhosis

Vlad Ratziu  1 , Luminita Bonyhay, Vincent Di Martino, Frederic Charlotte, Lucas Cavallaro, Marie-Hélène Sayegh-Tainturier, Philippe Giral, André Grimaldi, Pierre Opolon, Thierry Poynard
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Survival, liver failure, and hepatocellular carcinoma in obesity-related cryptogenic cirrhosis

Vlad Ratziu et al. Hepatology. 2002 Jun.

Abstract

Despite the rising incidence of obesity and diabetes, there is little emphasis on morbidity and mortality from obesity-related cirrhosis, usually considered a rare and asymptomatic condition. Our aim was to assess survival and the occurrence of hepatocellular carcinoma and complications of hepatic insufficiency in obesity-related cryptogenic cirrhosis compared with cirrhosis of other origins. We analyzed retrospectively 27 overweight patients with cryptogenic cirrhosis (CC-O), 10 lean patients with cryptogenic cirrhosis (CC-L) and 391 patients with hepatitis C virus-related cirrhosis (C-HCV). In CC-O patients, cirrhosis was detected later in life than in C-HCV and CC-L patients. Severe liver disease was as frequent in CC-O as in C-HCV patients as indicated by the proportion of Child B or C or of episodes of hepatic decompensation. Survival of CC-O patients was lower than that of untreated, age- and sex-matched C-HCV controls (P <.02 at 30 months), with a higher mortality of Child B or C patients. Hepatocellular carcinoma was detected in 8 of 27 (27%) CC-O patients versus 21% of matched C-HCV controls with a similar age cumulated incidence, suggesting a comparable carcinogenic potential. In conclusion, obesity-related cirrhosis should now be recognized as a distinct entity that can cause severe liver disease and death. Increased awareness of and better diagnostic strategies for nonalcoholic steatohepatitis in overweight patients are urgently needed.

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