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Etiology of liver cirrhosis in Japan: a nationwide survey

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Little is understood about worldwide changes in the epidemiological distribution of the etiology of liver cirrhosis (LC). The present study examines the etiology of liver cirrhosis in Japan using a nationwide survey.

Methods

We analyzed data from 33,379 patients with LC at 58 hospitals and presented the findings in a poster symposium regarding the etiology and clinical features of LC in Japan that was included in the program of the 44th Annual Meeting of the Japan Society of Hepatology. We identified the distribution of the etiology of LC and compared the present with previous Japanese findings to estimate the future of etiological changes in LC.

Results

The etiological agents were as follows: hepatitis B virus (HBV) 13.9%, hepatitis C virus (HCV) 60.9%, alcohol 13.6%, primary biliary cirrhosis (PBC) 2.4% and autoimmune hepatitis (AIH) 1.9%. Cirrhosis was considered to be related to nonalcoholic steatohepatitis (NASH) in 2.1% of the patients. The ratio of HCV-related LC was significantly higher among patients with hepatocellular carcinoma (HCC) (P < 0.0001) compared to those without, whereas the ratios of alcohol, PBC, AIH were lower. HCC was evident in 31.5% of NASH-related LC.

Conclusions

The major etiology of liver cirrhosis in Japan remains HCV. Our survey revealed the prevalence of NASH-related LC in Japan and the frequency of HCC. Future changes in etiology must be considered in establishing preventive or educational strategies, as well as in developing new treatment strategies.

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Abbreviations

AIH:

Autoimmune hepatitis

ANA:

Anti-nuclear antibody

BMI:

Body mass index

DM:

Diabetes mellitus

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

LC:

Liver cirrhosis

MetS:

Metabolic syndrome

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

PBC:

Primary biliary cirrhosis

PSC:

Primary sclerosing cholangitis

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Acknowledgments

The authors thank the collaborators at the 58 institutions who participated in the survey and provided the data.

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan

    Kojiro Michitaka, Yoichi Hiasa, Yoshio Tokumoto & Morikazu Onji

  2. Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Shuhei Nishiguchi

  3. Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences of Niigata University, 1-757 Asahimachi-Dori, Niigata, Niigata, 951-8122, Japan

    Yutaka Aoyagi

Authors
  1. Kojiro Michitaka
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  2. Shuhei Nishiguchi
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  3. Yutaka Aoyagi
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  4. Yoichi Hiasa
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  5. Yoshio Tokumoto
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  6. Morikazu Onji
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Consortia

The Japan Etiology of Liver Cirrhosis Study Group

Corresponding author

Correspondence to Morikazu Onji.

Additional information

Participating investigators of The Japan Etiology of Liver Cirrhosis Study Group are listed in the Appendix.

Appendix

Appendix

The Japan Etiology of Liver Cirrhosis Study Group consists of the following members: Takashi Goto (Akita University), Mamiko Takeuchi (Anjo Kosei Hospital), Shigeki Miyoshi (Asahikawa Medical College), Yutaka Yonemitsu (Chiba University), Ikuta Tanaka (Date Red Cross Hospital), Toshimitsu Murohisa (Dokkyo Medical University School), Yoshio Tokumoto (Ehime University Graduate School of Medicine), Yoshinori Horie (Eiju Sogo Hospital), Atsushi Takahashi (Fukushima Medical University School of Medicine), Makoto Shiraki (Gifu University Graduate School of Medicine), Hiroko Yamada (Gunma University Graduate School of Medicine), Ryoichi Okamoto (Hiroshima City Hospital), Takahiro Asakami (Hiroshima University), Shuhei Hige (Hokkaido University Hospital), Yoshiaki Inui (Hyogo Prefectural Nishinomiya Hospital), Kazuto Fukuda (Ikeda Municipal Hospital), Yuko Nagaoki (International Medical Center of Japan), Hidekatsu Kuroda (Iwate Medical University), Takuya Nagano (Kagawa Prefectural Central Hospital), Akihiro Deguchi (Kagawa University School of Medicine), Masayoshi Yamada (Kanazawa Medical University), Akito Sakai (Kanazawa University Graduate School of Medical Science), Nobuyuki Toshikuni (Kawasaki Hospital, Kawasaki Medical School), Keisuke Ojiro (Keio University School of Medicine), Chitomi Hasebe (Keiyukai Yoshida Hospital), Yoko Kudo (Kumamoto University of Medicine), Kazuhisa Nakamura (Kyorin University School of Medicine), Kanji Yamaguchi (Kyoto Prefectural University of Medicine), Eiji Takeshita (Matsuyama Red Cross Hospital), Satoshi Nakayama (Mishuku Hospital), Yuka Takahashi (Musashino Red-Cross Hospital), Shunsuke Nojiri (Nagoya City University Graduate School of Medical Sciences), Masao Fujimoto (Nara Medical University), Naota Taura (NHO Nagasaki Medical Center), Hiroshi Matsumura (Nihon University School of Medicine), Minoru Nomoto (Niigata University), Shinichi Fujioka (Okayama Saiseikai General Hospital), Bon Shoji (Okayama University Graduate School of Medicine), Hiroyasu Morikawa (Osaka City University School of Medicine), Ryoichi Ebara (Osaka Police Hospital), Mie Inao (Saitama Medical University), Ayana Endo (Sapporo City General Hospital), Hideyuki Nomura (Shin-Kokura Hospital), Satoru Jyoshita (Shinshu University School of Medicine), Yoshihiko Morisawa (Teikyo University School of Medicine), Takeshi Matsui (Teine Keijinkai Hospital), Masanori Ito (Tokyo Medical University Kasumigaura Hospital), Naoaki Hashimoto (Tokyo Teishin Hospital), Maki Tobari (Tokyo Women’s Medical University), Miharu Hirakawa (Toranomon Hospital), Kenji Oyama (Tottori University), Shingo Arakaki (University of Ryukyus), Makoto Kadokura (University of Yamanashi), Masanori Matsuda (University of Yamanashi), Tsuyoshi Matsumoto (Uwajima City Hospital), Satoshi Ugajin (Yamagata University), Makoto Segawa (Yamaguchi University Graduate School of Medicine) and Toshiya Ihii (Yokohama-city Seibu Hospital, St. Marianna University School of Medicine).

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Michitaka, K., Nishiguchi, S., Aoyagi, Y. et al. Etiology of liver cirrhosis in Japan: a nationwide survey. J Gastroenterol 45, 86–94 (2010). https://doi.org/10.1007/s00535-009-0128-5

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  • DOI: https://doi.org/10.1007/s00535-009-0128-5

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