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Z Gastroenterol 2014; 52(6): 558-563
DOI: 10.1055/s-0034-1366017
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Prevalence of Risk Factors for Liver Disease in a Random Population Sample in Southern Germany

Prävalenz von Risikofaktoren für eine Lebererkrankung in einer zufälligen Bevölkerungsstichprobe in Süddeutschland
M.-L. Huetter
1   Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany
,
M. Fuchs
2   Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, USA
,
M. M. Hänle
3   Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
,
R. A. Mason
4   Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA
,
A. S. Akinli
3   Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
,
A. Imhof
5   Department of Internal Medicine II, University Hospital Ulm, Ulm, Germany
,
W. Kratzer
,
R. Lorenz
3   Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
,
for the EMIL study group.* › Author Affiliations
Further Information

Publication History

08 August 2013

13 January 2014

Publication Date:
06 June 2014 (online)

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Abstract

Background: Chronic liver disease leads to fibrosis and cirrhosis of the liver. This may, in turn, result in chronic liver failure or the development of hepatocellular carcinoma (HCC). Main risk factors for chronic liver disease are viral hepatitis and alcoholism. The present study assessed a randomly selected population in southern Germany for risk factors for chronic liver disease such as fatty liver disease, viral hepatis infection and life-style factors. In addition, the potential association with elevated liver enzymes was investigated.

Methods: A total of 2256 subjects (1182 females, 1074 males), aged 18 − 65 years, participated in the study. Each subject underwent a standardized ultrasound examination, and anthropometric and biochemical assessments. Test subjects were randomly selected from the general population of a town in southwestern Germany. Data were acquired from November to December 2002 without further follow-up.

Results: Several factors were found to be associated with chronic liver disease in the study population. Alcohol consumption > 20 g/d was seen in 18.1 % (n = 409). Metabolic syndrome was diagnosed in 5.9 % (n = 132). The number of people with a BMI greater than 25 kg/m² was 45.1 % (n = 1017). The prevalence of subjects with chronic hepatitis B was 0.7 % (n = 15), that of anti-HCV positive patients, 0.6 % (n = 15). Elevated gGT was seen in 10.4 % (n = 14) of the patients. Prevalence of hepatic steatosis was 25.0 % (n = 564).

Conclusions: Many cases of chronic liver disease could be prevented by healthy nutrition, optimized medical treatment of associated disorders, and prevention strategies such as routine vaccination, in particular, against hepatitis B virus (HBV).

Zusammenfassung

Hintergrund: Chronische Lebererkrankungen führen zur Fibrose und Zirrhose der Leber: Dies kann wiederum zum chronischen Leberversagen oder zur Entwicklung eines hepatozellulären Karzinoms führen (HCC). Hauptrisikofaktoren für chronische Lebererkrankungen sind virale Hepatitis und Alkoholkonsum. In der vorliegenden Studie wurde die Prävalenz von Hepatitis B und C ermittelt sowie Risikofaktoren für chronische Lebererkrankungen wie Fettleber, virale Hepatitis und Lifestyle-Faktoren in einer zufälligen Bevölkerungsstichprobe untersucht.

Methoden: An der Studie nahmen 2256 Probanden (1182 Frauen, 1074 Männer) im Alter von 18 − 65 Jahren teil. Bei allen Probanden wurden standardisierte Ultraschalluntersuchungen und Laboruntersuchungen durchgeführt sowie anthropometrische Größen bestimmt. Die Probanden wurden von November bis Dezember 2002 zufällig aus einer Kleinstadt in Südwestdeutschland ausgewählt.

Ergebnisse: Die Ergebnisse zeigen, dass mehrere Faktoren mit einer chronischen Lebererkrankung assoziiert sind. Insgesamt 18,1 % der Probanden gaben einen Alkoholkonsum von über 20 g/Tag an. Das Metabolische Syndrom wurde bei 5,9 % (n = 132) der Probanden diagnostiziert. Insgesamt 45,1 % (n = 1017) der Teilnehmer hatten einen BMI über 25 kg/m². Die Prävalenz von chronischer Hepatitis B lag bei 0,7 % (n = 15), die von Anti-HCV bei 0,6 % (n = 15). Erhöhte gGT-Werte wurden bei 10,4 % (n = 14) der Probanden beobachtet. Die Prävalenz der Steatosis hepatis betrug 25 % (n = 564).

Schlussfolgerungen: In vielen Fällen könnten chronische Lebererkrankungen durch gesunde Ernährung, durch Präventionsstrategien wie routinemäßige Impfung, insbesondere gegen Hepatitis-B-Virus (HBV), verhindert werden.

Schlüsselwörter

Querschnittsstudien - Ultraschall - Fettleber - Hepatitis B - Hepatitis C

Key words

cross-sectional-studies - ultrasonography - fatty liver - hepatitis B - hepatitis C

* These authors contributed equally


 

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