Age and Ethnicity in Cirrhosis

Abstract

Background Cirrhosis is diagnosed in patients of all ages, and is the end result of many different diseases. The aim of this study was to characterize clinical and ethnic features of adult patients who were admitted to the hospital at different (young/old) ages and examine associations between age and ethnicity within these groups. Methods In this retrospective analysis of a diverse cohort of 2,017 patients with a clinical diagnosis of cirrhosis between January 2001 and December 2011; we focused on age, ethnicity, and outcome of patients with cirrhosis. Results We identified 219 patients under the age of 40, including 87/802 White (11%), 31/550 African American (6%) and 89/550 Hispanic patients (16%) (p<0.001). Ethnicity and causes of cirrhosis were found to have a significant correlation with age. Overall, Hispanic and White patients together were more than twice as likely to be diagnosed with cirrhosis at an age under 40 compared to African American patients (p<0.001). Autoimmune hepatitis caused cirrhosis at a younger age regardless of ethnicity (p<0.001), while cryptogenic/NAFLD/NASH was more likely identified at an older age (p=0.008). African American patients with cirrhosis due to either alcohol or HCV were older than Hispanic (p<0.001 and p=0.003, respectively) and White patients (p<0.001 and p<0.001, respectively) at presentation. Finally, younger patients admitted with cirrhosis had a higher in-hospital mortality rate (p<0.001). Conclusions The data suggest an association between ethnicity and age of cirrhosis diagnosis, both overall and in patients with certain cirrhosis etiologies. This work raises the possibility of an ethnic, and/or genetic basis for cirrhosis.

KIR2DL2/S2 and KIR2DS5 in alcoholic cirrhotic patients undergoing liver transplantation

“…Similar data were observed in other studies on different populations and periods of time [47][48][49]. It should be noted that slight differences with respect to this mean age have been described in other studies, suggesting a significant correlation between ethnicity and age of cirrhosis diagnosis, and the possibility of an ethnic and/or genetic basis for cirrhosis [50].…”

Aging and the Biological Response to Liver Injury

“…24 With regard to autoimmune liver disease, a recent study showed that cirrhosis due to autoimmune hepatitis was more frequently diagnosed at a young age compared with other causes of liver disease. 25 Cholestatic liver diseases are profoundly influenced by patient age too. A more severe disease course in young patients affected by primary biliary cholangitis (PBC) has been recently confirmed in a large retrospective study, showing increased risk of treatment failure, liver transplantation, and death.…”

NGF (−198C > T, Ala35Val) and p75NTR (Ser205Leu) gene mutations are associated with liver function in different histopathological profiles of the patients with chronic viral hepatitis in the Brazilian Amazon

“…The frequency of NGF variants, associated with the risk of progression of viral liver disease, prevailed in Europeans. Interestingly, this population is more susceptible to changes in periportal necrosis and hepatic fibrosis scores (about twice as likely, especially in patients under 40 years), as in serum transaminase levels (Crosse et al, 2004;Sajja et al, 2014). Although other studies have not identified differences in histological activity and inflammation index between Caucasians and Africans, it is notable that Caucasians had high levels of liver enzymes (Sterling et al, 2004).…”