Turkish Journal of Gastroenterology
Original Articles

Changing Trends in the Etiology of Cirrhosis in Türkiye: A Multicenter Nationwide Study

1.

Department of Gastroenterology, Mersin University Faculty of Medicine, Mersin, Türkiye

2.

Department of Internal Medicine, İstanbul Arel University Faculty of Medicine, İstanbul, Türkiye

3.

Department of Internal Medicine, Karaman Training and Research Hospital, Ankara, Türkiye

4.

Department of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye

5.

Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Türkiye

6.

Department of Gastroenterology, Mustafa Kemal University Faculty of Medicine, Hatay, Türkiye

7.

Department of Gastroenterology, Sakarya University Faculty of Medicine, Sakarya, Türkiye

8.

Department of Gastroenterology, Sanko University Faculty of Medicine, Gaziantep, Türkiye

9.

Department of Gastroenterology, Hacettepe University Faculty of Medicine, Ankara, Türkiye

10.

Department of Gastroenterology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye

11.

Department of Gastroenterology, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye

12.

Department of Gastroenterology, Dicle University Faculty of Medicine, Diyarbakır, Türkiye

13.

Department of Gastroenterology, Medipol University Faculty of Medicine, İstanbul, Türkiye

14.

Department of Internal Medicine, Karatay University Faculty of Medicine, Konya, Türkiye

15.

Department of Gastroenterology, Tokat Gaziosmanpaşa University Faculty of Medicine, Tokat, Türkiye

16.

Department of Gastroenterology, İstanbul University Istanbul Faculty of Medicine, İstanbul, Türkiye

17.

Department of Gastroenterology, Medicana Atakoy Hospital, Kayseri, Türkiye

18.

Department of Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye

19.

Department of Gastroenterology, Koç University Faculty of Medicine, İstanbul, Türkiye

20.

Department of Gastroenterology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye

21.

Department of Gastroenterology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Türkiye

22.

Department of Gastroenterology, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakir, Türkiye

23.

Department of Gastroenterology, İstinye University Faculty of Medicine, İstanbul, Türkiye

24.

Department of Gastroenterology, Ankara Etlik City Hospital, Ankara, Türkiye

25.

Department of Gastroenterology, Marmara University Faculty of Medicine, İstanbul, Türkiye

26.

Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Türkiye

Turk J Gastroenterol 2024; 35: 772-777
DOI: 10.5152/tjg.2024.23572
Read: 673 Downloads: 383 Published: 02 September 2024

Background/Aims: The aim of our study was to investigate the underlying causes behind the etiology of cirrhosis in Türkiye.

Materials and Methods: The study was comprised of patients with cirrhosis located in the gastroenterology clinics of 28 centers in Türkiye between January 2000 and June 2021.

Results: The study group consisted of 4953 cirrhotic patients (median age: 62.2 years, male / female: 58% / 42%). Among the patients, 39% of the patients were compensated, and 61% were decompensated. Furthermore, 47.5% had Child-Pugh class A, 38% had ChildPugh class B, and 14.5% had Child-Pugh class C. The most frequent complaints were abdominal bloating (28%). Ascites (54.2%) was the most common manifestation of decompensation. The median Child-Pugh and MELD-Na scores were 7.0 and 10.0, respectively. The most common cause of cirrhosis was chronic viral hepatitis (43%), followed by cryptogenic cirrhosis (CC) (19%), metabolic dysfunction-associated steatotic liver disease (MASLD)-related cirrhosis (13%), and alcohol-related cirrhosis (11%). Among the 950 patients with CC, 416 had metabolic abnormalities. If these 416 CC patients with metabolic abnormalities were categorized as having MASLDrelated cirrhosis, the proportion of MASLD-related cirrhosis increased to 21%. Thirteen percent of the patients were diagnosed with HCC, while 4% had extrahepatic malignancy. Female breast cancer (18%) and colorectal cancer (18%) were the most frequent extrahepatic malignancies.

Conclusion: Viral hepatitis remains the main cause of cirrhosis in Türkiye. However, its prevalence seems to be declining, whereas the prevalence of steatotic liver disease-related cirrhosis is increasing.

Cite this article as: Üçbilek E, Yıldırım AE, Ellik Z, et al. Changing trends in the etiology of cirrhosis in Türkiye: A multicenter nationwide study. Turk J Gastroenterol. 2024;35(10):772-777.

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