Who gets liver cirrhosis? You may be surprised.
New Ontario study has found that cirrh rates increase the fastest among young adults. An epidemic of fatty liver disease is emphasized as one possible cause for the spin.
Having considered older men's disease, the liverworts face changing, says the study authors published in The Lancet Gastroenterology and Hepatology magazine on Thursday.
New causes of chiroposis almost doubled in Ontario between 1997, when 6,318 people were diagnosed, and 2016, when 12,047 people were diagnosed. Nearly one per cent of the population of cirrhosis, according to the retrospective study based on the population of the Institute of Clinical Evaluation Sciences.
Young adults and women are a population of high growth for potential deadly liver disease. The risk of cyrhosis is 116 percent higher for millennials born in 1990 than Baby Boomers born in 1951. For women, the risk is even higher. A woman born in 1990 was 160 per cent more likely to be diagnosed with cirrhosis than a woman born in 1951.
"Cyrhosis is traditionally considered to be an older man's disease, but our data shows that the surface of a cirus is changing," said Dr Jennifer Flemming, lead author of the study. Flemming is an assistant scientist at Queen's ICES and an assistant professor at the Queen's University.
Liquid cytosis is indicated by replacing normal liver tissue with scarf tissue. The symptoms of cirrhosis include jaundice, swelling and ankles and abdomen, grow, tiredness and losing appetite. Generally, people with fatty liver disease have no symptoms, although some can report fat feelings and general feeling of being ill.
"More young people are diagnosed with cirosis earlier than they had previously," said Flemming. "If these types of trends continue, they will lead to a significant burden on the healthcare system."
The next step, says Flemming, is to identify precisely the causes of the increase in cirosis among young adults and women. Fatty fatty liver disease, which is now the main cause of liver disease, is a likely link.
Historically, the use of alcohol and hepatitis C are the most common causes of liver cirosis. But with effective treatment for hepatitis C, it is turned to a fatty liver that is not alcoholic.
It is currently in 20-30 percent of the population. Twenty-two percent of those cases are more serious and at risk of having cirrhosis, according to the study. Among people with diabetes, NAFLD rates, as is known, are 80 percent. In its most severe form, the disease can lead to patients requiring younger transplants.
Although it is associated with obesity, it is not only the disease of people who are obese, says Flemming. Genetics puts some people at higher risk. It can be reversed if a patient follows a healthy lifestyle, including a balanced diet and exercise, according to the Liver Liver Foundation.
High rates of NAFLD, especially among three year olds, may be part of the reason for increasing the incidence of cirosis among young adults and women, the report says.
Alcohol also remains a key cause of cirosis, says Flemming. The study's findings should address the trends of drinking among young adults. Some studies have found that young women in North America now drink at the same rates as young men, and women are more likely to develop alcohol-related liver disease.
As with non-alcoholic fatty liver disease, some people are at higher risk of developing cirrhosis than others, said Flemming, who works as a gastroenterologist at Kingston General Hospital.
"I see many people who use a lot of alcohol that would not be classified as a disorder in alcohol use, but because of other factors that are predicted to have a cirrhosis," he says.
Public health strategies need to raise awareness of cirosis among young adults and women, non-traditional groups that are associated with high risk of the disease.
"This is a public health issue because many cases of cirrhosis, including viral hepatitis and alcohol consumption, are treated and ultimately can stop stroke," he said.
Flemming said he is not unusual to see young adults with cirosis in his clinical practice. "Certainly, we've seen many young people who need the junior transplant. I was the youngest person this year."
And patients often have no idea before they are diagnosed.
Flemming said she liked raising awareness of the issue and also seeing some of the stigma that he had to pull.
"Strategies are needed to raise awareness of this tranquil epidemic in adults and young women."
Illness by the numbers
Canada has 7% non-alcoholic fatty liver disease
20 per cent of people with non-alcoholic steatohepatitis (NASH), the most serious type of non-alcoholic fatty liver disease can develop seirosis
11 percent of NASH patients can die from the disease
500 liver transplants were held in Canada
400 people were waiting for a junior transplant
90 children and adults died while waiting
Since 1970, liver cancer has doubled in women
Source: Liver Liver Foundation
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