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Abstract：
UNASSIGNED: The incidence of cirrhosis in Iceland has been the lowest in the world with only 3 cases per 100,000 inhabitants. Alcohol consumption has almost doubled in Iceland from 1980 to 2016. Obesity has also risen and hepatitis C virus has spread among people who inject drugs in Iceland. The aim of this study was to evaluate the effects of these risk factors on the incidence and aetiology of cirrhosis in Iceland.
UNASSIGNED: The study included all patients diagnosed with cirrhosis for the first time during 2010-2015. Diagnosis was based on liver histology or 2 of 4 criteria: cirrhosis on imaging, ascites, varices, and/or elevated INR.
UNASSIGNED: Overall, 157 patients were diagnosed, 105 (67%) males, mean age 61 years. The overall incidence was 9.7 cases per 100,000 inhabitants annually. Alcohol was the only underlying cause in 48/157 (31%), non-alcoholic fatty liver disease (NAFLD) in 34/157(22%), and alcohol and hepatitis C together in 23/157(15%) were the most common causes. Only 6% of patients had an unknown cause of cirrhosis. Upon diagnosis, the median model for end-stage liver disease score was 11 (IQR 8-15), 53% were of Child-Pugh class A whereas 61 (39%) had ascites, 11% encephalopathy, and 8% variceal bleeding. In all, 25% of deaths were from HCC and 25% from liver failure.
UNASSIGNED: A major increase in incidence of cirrhosis has occurred in Iceland associated with increases in alcohol consumption, obesity, and hepatitis C. In a high proportion NAFLD was the aetiology and very few had unknown cause of cirrhosis. The highest death rate was from HCC.
UNASSIGNED: In a nationwide population-based study from Iceland, including all patients diagnosed with cirrhosis of the liver over a period of 5 years, we found the incidence of new cases had increased 3-fold compared with a previous study 20 years ago. The increase is attributable to increased alcohol consumption, an epidemic of diabetes and obesity, and infection with the hepatitis C virus. Furthermore, we found that with thorough investigations, a specific cause for cirrhosis could be found in 94% of patients. Patients with cirrhosis frequently die of liver cancer and other complications related to their liver disease.
UNASSIGNED: The study included all patients diagnosed with cirrhosis for the first time during 2010-2015. Diagnosis was based on liver histology or 2 of 4 criteria: cirrhosis on imaging, ascites, varices, and/or elevated INR.
UNASSIGNED: Overall, 157 patients were diagnosed, 105 (67%) males, mean age 61 years. The overall incidence was 9.7 cases per 100,000 inhabitants annually. Alcohol was the only underlying cause in 48/157 (31%), non-alcoholic fatty liver disease (NAFLD) in 34/157(22%), and alcohol and hepatitis C together in 23/157(15%) were the most common causes. Only 6% of patients had an unknown cause of cirrhosis. Upon diagnosis, the median model for end-stage liver disease score was 11 (IQR 8-15), 53% were of Child-Pugh class A whereas 61 (39%) had ascites, 11% encephalopathy, and 8% variceal bleeding. In all, 25% of deaths were from HCC and 25% from liver failure.
UNASSIGNED: A major increase in incidence of cirrhosis has occurred in Iceland associated with increases in alcohol consumption, obesity, and hepatitis C. In a high proportion NAFLD was the aetiology and very few had unknown cause of cirrhosis. The highest death rate was from HCC.
UNASSIGNED: In a nationwide population-based study from Iceland, including all patients diagnosed with cirrhosis of the liver over a period of 5 years, we found the incidence of new cases had increased 3-fold compared with a previous study 20 years ago. The increase is attributable to increased alcohol consumption, an epidemic of diabetes and obesity, and infection with the hepatitis C virus. Furthermore, we found that with thorough investigations, a specific cause for cirrhosis could be found in 94% of patients. Patients with cirrhosis frequently die of liver cancer and other complications related to their liver disease.
摘要：
冰岛肝硬化的发病率是世界上最低的，每10万居民中只有3例。从1980年到2016年，冰岛的酒精消费量几乎翻了一番。肥胖也有所上升，丙型肝炎病毒在冰岛注射毒品的人群中传播。这项研究的目的是评估这些危险因素对冰岛肝硬化发病率和病因的影响。
■该研究包括2010-2015年首次诊断为肝硬化的所有患者。诊断基于肝组织学或4个标准中的2个：影像学上的肝硬化，腹水,静脉曲张,和/或升高的INR。
■总的来说，157名患者被确诊，105名（67%）男性，平均年龄61岁。总发病率为每年每10万居民9.7例。酒精是48/157（31％）中唯一的根本原因，非酒精性脂肪性肝病（NAFLD）34/157（22％），23/157（15％）的酒精和丙型肝炎是最常见的原因。只有6%的患者有不明原因的肝硬化。诊断后,终末期肝病模型评分中位数为11（IQR8-15），53%是Child-PughA级，而61(39%)有腹水，11%脑病,和8%的静脉曲张出血.总之,25%的死亡来自HCC，25%来自肝功能衰竭。
■冰岛的肝硬化发病率大幅增加与饮酒增加有关，肥胖，和丙型肝炎在高比例的NAFLD是病因，很少有不明原因的肝硬化。死亡率最高的是HCC。
■在一项来自冰岛的全国性人口研究中，包括在5年内诊断为肝硬化的所有患者，我们发现,与20年前的研究相比,新发病例的发生率增加了3倍.增加是由于酒精消费增加，糖尿病和肥胖症的流行，和丙型肝炎病毒感染。此外，我们发现经过彻底的调查，在94%的患者中可以发现肝硬化的具体原因。肝硬化患者经常死于肝癌和其他与肝脏疾病相关的并发症。
■该研究包括2010-2015年首次诊断为肝硬化的所有患者。诊断基于肝组织学或4个标准中的2个：影像学上的肝硬化，腹水,静脉曲张,和/或升高的INR。
■总的来说，157名患者被确诊，105名（67%）男性，平均年龄61岁。总发病率为每年每10万居民9.7例。酒精是48/157（31％）中唯一的根本原因，非酒精性脂肪性肝病（NAFLD）34/157（22％），23/157（15％）的酒精和丙型肝炎是最常见的原因。只有6%的患者有不明原因的肝硬化。诊断后,终末期肝病模型评分中位数为11（IQR8-15），53%是Child-PughA级，而61(39%)有腹水，11%脑病,和8%的静脉曲张出血.总之,25%的死亡来自HCC，25%来自肝功能衰竭。
■冰岛的肝硬化发病率大幅增加与饮酒增加有关，肥胖，和丙型肝炎在高比例的NAFLD是病因，很少有不明原因的肝硬化。死亡率最高的是HCC。
■在一项来自冰岛的全国性人口研究中，包括在5年内诊断为肝硬化的所有患者，我们发现,与20年前的研究相比,新发病例的发生率增加了3倍.增加是由于酒精消费增加，糖尿病和肥胖症的流行，和丙型肝炎病毒感染。此外，我们发现经过彻底的调查，在94%的患者中可以发现肝硬化的具体原因。肝硬化患者经常死于肝癌和其他与肝脏疾病相关的并发症。
