Hepatitis B and alcohol-related liver disease are most common causes of cirrhosis among men
But a form of liver disease related to obesity is on the rise
Cirrhosis is ‘not an equal-opportunity killer’
SEATTLE – Twice as many men as women are dying from liver cirrhosis, according to a new scientific study.
Globally, cirrhosis caused more than 1.3 million deaths in 2017, two-thirds of which were men. Hepatitis B caused the greatest proportion of deaths among men, followed by alcohol-related liver disease.
“Cirrhosis is not an equal-opportunity killer,” said Dr. Mohsen Naghavi, senior author on the study and Professor of Health Metrics Sciences at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine. “Hepatitis B and the excessive use of alcohol take a particularly high toll on men. This reaffirms our earlier study in 2018 showing there is no safe level of alcohol use.”
Published this week in the international medical journal The Lancet, the study is part of the annual Global Burden of Disease study (GBD). The analysis provides comparable estimates of cirrhosis deaths across 195 countries and territories. Researchers analyzed five underlying causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, an advanced form of non-alcoholic fatty liver disease, and other causes.
Naghavi and coauthors found the number of people living with cirrhosis due to advanced non-alcoholic fatty liver disease more than doubled since 1990, from 4.4 million to 10.3 million in 2017. That cause is most common in patients who are overweight or obese.
“We found that in the near future, non-alcoholic fatty liver disease could become the leading cause of cirrhosis,” said Naghavi. “This underscores the fact that rising rates of obesity remain a serious public health challenge that cannot be ignored.”
Study authors noted cirrhosis-related deaths can generally be prevented through vaccinations or changes in one’s lifestyle and diet.
Additional findings include:
- The proportion of all global deaths from cirrhosis increased between 1990 and 2017, from 1.9% to 2.4%.
- Generally, women had a lower proportion of cirrhosis deaths caused by hepatitis B and alcohol-related liver disease than men, and had a higher proportion due to advanced non-alcoholic fatty liver disease.
- The cirrhosis death rate (age-adjusted) was highest in Egypt in 2017 at 103.3 deaths per 100,000 and lowest in Singapore at 3.7.
- The eight countries with the largest increases in the cirrhosis death rates (age-adjusted) since 1990 were in Eastern Europe and Central Asia:
- Lithuania (177%), Ukraine (167%), Belarus (163%), Russia (152%), Kazakhstan (138%), Estonia (106%), Latvia (104%), and Armenia (85%).
- Cirrhosis deaths in Eastern Europe and Central Asia in 2017 were primarily caused by alcohol-related liver disease.
About the Institute for Health Metrics and Evaluation
The Institute for Health Metrics and Evaluation (IHME) is an independent global health research organization at the University of Washington that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. IHME is committed to transparency and makes this information widely available so that policymakers have the evidence they need to make informed decisions on allocating resources to improve population health.
About the Global Burden of Disease study
The Global Burden of Disease (GBD) study is the largest and most comprehensive effort to quantify health loss across places and over time. It draws on the work of more than 4,800 collaborators from 147 countries and territories. The Institute for Health Metrics and Evaluation coordinates the study. The GBD 2017 study was published in November 2018 and includes more than 38 billion estimates of 359 diseases and injuries and 84 risk factors in 195 countries and territories from 1990 to 2017.