Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2017; 23(8): 1458-1468
Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1458
Clinical features and natural history of cryptogenic cirrhosis compared to hepatitis C virus-related cirrhosis
Luca Rinaldi, Fabio Nascimbeni, Mauro Giordano, Chiara Masetti, Barbara Guerrera, Annalisa Amelia, Maria Chiara Fascione, Stefano Ballestri, Dante Romagnoli, Rosa Zampino, Riccardo Nevola, Enrica Baldelli, Natalina Iuliano, Valerio Rosato, Amedeo Lonardo, Luigi Elio Adinolfi
Luca Rinaldi, Mauro Giordano, Barbara Guerrera, Annalisa Amelia, Maria Chiara Fascione, Rosa Zampino, Riccardo Nevola, Natalina Iuliano, Valerio Rosato, Luigi Elio Adinolfi, Internal Medicine, Clinical Hospital of Marcianise, Second University of Naples, 80100 Naples, Italy
Luca Rinaldi, Mauro Giordano, Barbara Guerrera, Annalisa Amelia, Maria Chiara Fascione, Rosa Zampino, Riccardo Nevola, Natalina Iuliano, Valerio Rosato, Luigi Elio Adinolfi, Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, Second University of Naples, 80100 Naples, Italy
Fabio Nascimbeni, Chiara Masetti, Dante Romagnoli, Enrica Baldelli, Amedeo Lonardo, Outpatient Liver Clinic and Internal Medicine, NOCSAE, Baggiovara, Azienda USL, Modena; University of Modena and Reggio Emilia, 41121 Modena, Italy
Stefano Ballestri, Internal Medicine, Pavullo Hospital, Azienda Sanitaria Locale, Pavullo, 41121 Modena, Italy
Author contributions: Rinaldi L, Nascimbeni F, Lonardo A and Adinolfi LE contributed to conception and designed the study, analysis and interpretation of data, and wrote the manuscript; Giordano M, Masetti C, Guerrera B, Amelia A, Fascione MC, Ballestri S, Romagnoli D, Zampino R, Nevola R, Baldelli E, Iuliano N and Rosato V maintained the database, followed the patients and reviewed the literature; all the authors made critical revision and approved the final version of the manuscript.
Institutional review board statement: The study was approved by the Local Institutional Research Committees.
Informed consent statement: The enrolled patients provide informed written consent.
Conflict-of-interest statement: There is no conflict of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Luigi Elio Adinolfi, Professor, Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, Second University of Naples, Piazza Miraglia, 80100 Napoli, Italy. luigielio.adinolfi@unina2.it
Telephone: +39-81-5665081 Fax: +39-81-5665080
Received: August 24, 2016
Peer-review started: August 27, 2016
First decision: September 20, 2016
Revised: November 21, 2016
Accepted: January 18, 2017
Article in press: January 18, 2017
Published online: February 28, 2017
Core Tip

Core tip: We evaluated the features and outcomes of cryptogenic cirrhosis (CC) compared to age- and Child-Pugh class-matched hepatitis C virus-related cirrhosis at baseline and over a 42-mo follow-up. At diagnosis, the median age of CC was 66 years and Child-Pugh classes A/B/C were 47%/31%/22%, respectively. Among CC cases higher prevalences of metabolic syndrome, overweight/obesity, high BMI, impaired glucose metabolism, high blood pressure, dyslipidemia, hyperuricemia, cardiovascular diseases, extrahepatic cancer, and gallstones were observed. Although in the two groups we detected a similar incidence of liver decompensation, hepatocellular carcinoma (HCC) and death, an earlier development of HCC was observed in CC. Age and Child-Pugh were predictors of death. Most CC cases are the consequence of undiagnosed nonalcoholic fatty liver disease.