Cirrhosis of the liver is a "silent epidemic" among younger adults, women


Who gets liver cirrhosis? You might be surprised.

A new study by Ontario found that rates of cirrhosis among young adults are rapidly increasing. The epidemic of fatty liver disease is exposed as one of the possible causes for the tip.

Once considered a disease of elderly men, the cirrhosis of the liver is changing, the authors of the study, published in The Gastroenterology and Hepatology Lancet on Thursday, say.

New cases of cirrhosis almost doubled in Ontario between 1997, when 6,318 people were diagnosed and in 2016, when 12,047 people were diagnosed. According to data from a retrospective population study from the Institute of Clinical Evaluation Sciences, almost one percent of the population is cirrhosis.

Young adults and women are a very growing population of potentially lethal liver disease. The risk of cirrhosis is 116 per cent greater for the millennia born in 1990 than Baby Boomers, born in 1951. For women, the risk is even higher. A woman born in 1990 was 160% more likely to diagnose cirrhosis than a woman born in 1951.

"Traditionally there was a cirrhosis of older men, but our data suggest that the face of the cirrhosis changes," said Dr. Jennifer Flemming, lead author of the study. Flemming is a research assistant at the Queen of ICES and an assistant at Queen's University.

Liver cirrhosis is characterized by the replacement of normal liver tissue with scar tissue. Symptoms of cirrhosis include jaundice, swelling of the ankles and abdomen, itching, fatigue and loss of appetite. In general, people with hepatic impairment of the liver have no symptoms, although some may report feelings of fatigue and a general sense of well-being.

"Several young people are diagnosed with cirrhosis at an earlier age than before," said Flemming. "If these types of trends continue, they will have a big burden on the healthcare system."

Empty hospital bed.

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The next step, said Flemming, is to determine the precise causes of the increase in cirrhosis between young adults and women. Probably the link is non-alcoholic fatty liver disease, which is now the leading cause of liver disease.

In the past, the use of alcohol and hepatitis C was the most common cause of liver cirrhosis. But with effective treatment for hepatitis C, attention is turned into non-alcoholic fatty liver disease.

It is present in 20-30% of the population. Twenty per cent of these cases are more difficult and risky for cirrhosis after the study. Among people with diabetes, NAFLD levels are known to be 80 percent. In the worst form, the disease can cause patients who need liver transplantation.

Although it is associated with obesity, it is not just a disease of people who are obese, said Flemming. Genetics poses a greater risk to some people. It can turn if the patient follows a healthy lifestyle, including a balanced diet and physical exercise, according to the Canadian Foundation Foundation.

A woman raises weight during training at the crossroads.


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Perhaps high levels of NAFLD, especially during the millennia, are part of the cause of rising cirrhosis among young adults and women, the report says.

Alcohol remains a key cause of cirrhosis, said Flemming. The findings of the study should highlight the trends of drinking in young adults. Some studies have shown that young women in North America now drink the same way as young men and women are more susceptible to liver disease related to alcohol.

A young couple enjoying a conversation and a glass of wine.

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As with non-alcoholic fatty acids, some people have a greater risk of developing cirrhosis than others, said Flemming, who works as a gastroenterologist at the Kingston General Hospital.

"I see many people who use alcohol that they would not classify as an alcohol disorder, but because of other factors caused by cirrhosis," she said.

Public health strategies are needed to raise awareness of cirrhosis among young adults and women, groups that are not traditionally associated with a high risk of developing the disease.

"This is a matter of public health, as many causes of cirrhosis, including viral hepatitis and alcohol consumption, can be cured and finally cirrhosis can be prevented," she said.

Flemming said that in her clinical practice unusual young adults with cirrhosis were not seen. "We have certainly seen many young people who need liver transplantation. The youngest person I saw this year is 25."

And patients often have no idea before diagnosing them.

Flemming said she wanted to raise awareness about this issue and also remove some stigma.

"Strategies are needed to increase awareness of this silent epidemic in young adults and women."

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Liver disease with numbers

7 million Canadians have a non-alcoholic fatty liver disease

20 percent of people with non-alcoholic steatohepatitis (NASH), the worst form of non-alcoholic fatty liver disease, can develop cirrhosis

11% of patients with NASH can die due to illness

In 2016:

There were 500 transplantations of liver in Canada

400 people were waiting for a liver transplant

During the wait, 90 children and adults died

Since 1970, the liver cancer has doubled in women

Source: Canadian Foundation for Liver

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