Who is getting liver cirrhosis? You might be surprised.
A new Ontario study found that cirrhosis is the fastest growing youth. The fatty liver disease epidemic is listed as one of the possible spikes.
Researchers from the The Lancet Gastroenterology and Hepatology magazine, said the study's review of older men's disease, is changing the face of liver cirrhosis.
New cases of cirrhosis almost doubled in Ontario since 1997, when 6,318 people were diagnosed, and in 2016, when 12,047 people were diagnosed. According to a retrospective population survey conducted by the Clinical Evaluative Sciences Institute, almost one percent of the population now has cirrhosis.
Young adults and women are potentially lethal liver disease patients with high growth. The risk of cirrhosis is 116 percent higher in the thousands of years old, born in 1990 than the Baby Boomers born in 1951. The risk for women is even greater. A 1990-year-old woman was 160 percent more likely to be diagnosed with cirrhosis than a woman born in 1951.
"Traditionally, cirrhosis is thought to be an older male disease, but our data suggests that cirrhosis is changing," said Jennifer Fleming, lead author of the study. Flemmings is an ICES Queen Adjunct and associate professor 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, tiredness and loss of appetite. Usually people with oily liver disease have no symptoms, although some may report a feeling of fatigue and general feeling of being unwell.
"Several young people are diagnosed with cirrhosis at an early age," Fleming says. "If these trends continue, they will pose a significant burden on the healthcare system."
The next step, Fleming says, is to pinpoint precise reasons for increasing cirrhosis among young people and women. A possible link is the non-alcoholic fatty liver disease, which is the main cause of liver disease.
Historically, alcohol use and hepatitis C are the most common causes of liver cirrhosis. But, effectively treating hepatitis C, attention is focused on non-alcoholic fatty liver disease.
It is located in 20-30% of the population. According to a study, twenty percent of these cases are more severe and at risk of cirrhosis. For people who have diabetes, NAFLD rates are known to be 80 percent. In a more severe form, the disease can cause a patient who needs liver transplantation.
Although it's associated with obesity, it's not just a sick person that is obese, Fleming says. Genetics makes some people more at risk. According to the Canadian Liver Foundation, it can be changed if the patient follows a healthy lifestyle, including a balanced diet and physical activity.
The report states that a high NAFLD level, especially between the millennium years, is part of the adult years of cirrhosis in young adults and women.
Alcohol is also the leading cause of cirrhosis, Fleming says. Research findings should focus on drinking trends among young people. Some studies have found that young women in North America drink at the same rate as young men, and women are more likely to be exposed to alcohol-related liver disease.
As with non-alcoholic fatty liver disease, some people have a higher risk of cirrhosis than others, said Flemings, who works as a gastroenterologist at the Kingston General Hospital.
"I see a lot of people who consume alcohol that does not consider them to be alcohol abuse, but because of other factors it causes them cirrhosis," she said.
Public health strategies are needed to increase awareness of cirrhosis among young people and women who are not usually at high risk of illness.
"This is a public health problem, as many of the causes of cirrhosis, including viral hepatitis, and alcohol use are curable, and ultimately cirrhosis can be prevented," she said.
Fleming said that in her clinical practice, it's not unusual to see young people with cirrhosis. "We have certainly seen many young people who need liver transplantation, the latest in this year, when I saw it, was 25."
And patients often have no idea before they are diagnosed.
Fleming says he wants to raise awareness of the issue, and find out which bias has been removed.
"Strategies are needed to raise awareness of this silent epidemic for young people and women."
Liver disease by digits
7 million Canadians have non-alcoholic fatty liver disease
20 percent of people with non-alcoholic steatohepatitis (NASH), the heaviest type of non-alcoholic fatty liver disease, can develop cirrhosis
11 percent of NASH patients may die from illness
500 liver transplants were done in Canada
400 people were waiting for liver transplantation
In anticipation, 90 children and adults died
Since the 1970s, liver cancer has doubled in women
Source: Canadian Liver Foundation
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