Prevalence of Liver Disease in Russia’s Largest City: A Population-based Study

Komova A.^1, , Maevskaya M.¹ and Ivashkin V.¹

¹Hepatology department, I.M.Sechenov First State Medical University, Moscow, Russia

Cite this paper

Komova A., Maevskaya M. and Ivashkin V.. Prevalence of Liver Disease in Russia’s Largest City: A Population-based Study. American Journal of Clinical Medicine Research. 2014; 2(5):99-102. doi: 10.12691/AJCMR-2-5-2

Abstract

Background and aim: Difficulties in accessing data from individual countries, especially Russia, hinder global evaluation of liver disease in Europe. The aim of this study is to estimate the prevalence of liver disease in Moscow, Russia’s capital and most densely populated urban area. Methods: We recruited 5,000 random Moscow residents over the age of 18 in a population-based cross-sectional study. Participants were screened for liver disease between October 2012 and November 2012. Socio-demographic, health and lifestyle information was obtained via questionnaire; alcohol screening was done using CAGE and AUDIT tools; BMI was measured by physical exam; liver tests (ALT, AST, GGTP, bilirubin, ALP, ALT/AST), anti-HCV, HBsAg, and γ-globulins were checked by laboratory analysis; an abdominal ultrasound was performed for all patients. Provisional diagnoses were formed for all participants according to our established algorithm. Results: In total, 4,768 participants completed screening. Socio-demographic data: male 1,671 (33.42%), female 3,329 (66.58%), average age 45 years, average BMI 26.2 kg/m². Average BMI >25 kg/m² was observed among the following occupational groups: retired, disabled, military and businessmen. Health care workers and students were the “slimmest” occupational groups, with only 24.7% and 21.8% having BMI >25 kg/m² respectively. The CAGE and AUDIT questionnaires revealed that a huge number of participants (74.64% of all participants) should reduce the quantity of alcohol they consume, and that 9.8% abuse alcohol or are alcohol dependent. Overall, 1,459 subjects (30.6%, m:f=2:1) had at least one abnormality in liver function tests. We found the following prevalence of liver diseases in Russia’s largest city: NAFLD 7.4% (n=352), ALD 6.9% (n=329), hepatitis C 6.7% (n=322), hepatitis B 1.9% (n=91), DILI 0.82% (n=39), cholestasis 0.69% (n=33), AIH 0.78% (n=37), other forms of liver disease 5.4% (n=258). Conclusions: According to our study, more than one quarter of Moscow residents have abnormal liver tests that may indicate liver disease. NAFLD, ALD and hepatitis C were the main causes of abnormal tests. The primary risk factors for abnormal liver tests as determined by multivariable analysis were: young age (30-59 years, p<0.001), alcohol abuse (AUDIT score >16, p<0.04), and hypercholesterolemia (p=0.016). 80.3% of patients with abnormal liver tests required etiotropic treatment.

Keywords

Russia, prevalence, liver disease, epidemiology

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Bedogni G, Miglioli L, Masutti F, Castiglione A, Croce LS, Tiribelli C, et al. “Incidence and natural course of fatty liver in the general population: the Dionysos study”, Hepatology, 46: 1387-1391. 2007.
[2]	Bell BP, Manos MM, Zaman A. “The epidemiology of newly diagnosed chronic liver disease in gastroenterology practices in the United States: results from population-based surveillance”. Am J Gastroenterol, 103(11): 2727-36; Nov. 2008.
[3]	Bueverov A.O., Gotie S.V., Eramishancev A.K., Zhdanov K.V., Ivashkin V.T., Lobzin U.V., Maevskaya M.V., Nikitin I.G., Chzhao A.V. Diffuse liver diseases diagnosis and treatment, Moscow, 2003, 68.
[4]	Chalasani Naga, Younossi Zobair et al. “The Diagnosis and Management of Non-Alcoholic Fatty Liver Disease: Practice Guideline by the American Association for the Study of Liver Diseases”, American College of Gastroenterology, and the American Gastroenterological Association. 2012.
[5]	Ghany M. G., Strader D.B., Thomas D.L., Seeff L.B. Diagnosis, Management, and Treatment of Hepatitis C: an update. AASLD Practice Guideline update, 2009.
[6]	Ivashkin V.T., Maevskaya M.V. Alcohol and virus induced liver diseases, Moscow, 2007, 156.
[7]	Imhof A, Kratzer W, Boehm B, Meitinger K, Trischler G, Steinbach G, et al. “Prevalence of nonalcoholic fatty liver and characteristics in overweight adolescents in the general population”, Eur J Epidemiol. 22:889-897. 2007.
[8]	Lok Anna S. F., McMahon B. J. Chronic Hepatitis B. Update AASLD Practice Guideline update, 2009.
[9]	Maevskaya M.V., Ivashkin V.T., German E.N. “How to investagate patients with abnormal liver tests and absence of symptoms”, RGGGC, V.23, №4, 45-68, 2013.
[10]	Maevskaya M.V. Chronic liver diseases induced by alcohol and hepatitis B and C viruses, thesis for a Doctor's degree, Moscow, 2006.
[11]	Maevskaya M.V., Ivashkin V.T., Method to screen liver diseases and system for it’s realization, patent № 2523661 (Russia); 22.08.2013, 84.
[12]	Manns Michael P., Czaja Albert J., Gorham James D. et al. Diagnosis and Management of Autoimmune Hepatitis, AASLD Practice guidelines. 2010.
[13]	Martin Blachier, Henri Leleu, Markus Peck-Radosavljevic, Dominique-Charles Valla and Françoise Roudot-Thoraval The Burden of liver disease in Europe. A review of available epidemiological data. 2013.
[14]	O’Shea Robert S., Dasarathy Srinivasan, Arthur J. McCullough, and the Practice Guideline Committee of the American Association for the Study of Liver Diseases and the Practice Parameters Committee of the American College of Gastroenterology, Alcoholic Liver Disease, Hepatology. 2010.
[15]	Shahgildyan I.V., Ershova O.N., Michailov M.I. et al. “Modern acute and chronic hepatitis C statistics in Russia”, International epidemiological symposium, Brest, 184-186, 2011.