Z Gastroenterol 2012; 50 - V63
DOI: 10.1055/s-0032-1323912

Klinische Präsentation chronischer Lebererkrankungen in Deutschland: Rolle von Ätiologie, Alter und Geschlecht.

A Tromm 1, J Petersen 2, P Buggisch 2, S Holm 3, R Link 4, K Böker 5, G von Dewitz 6, A Schober 7, C John 8, U Naumann 9, V Meister 10, V Gülberg 11, H Blaak 12, A Heuser 12, M Bilzer 12
  • 1Ev. Krankenhaus Hattingen GmbH, Klinik für Innere Medizin, Hattingen, Germany
  • 2ifi Institute, Hamburg, Germany
  • 3Praxis Georgstrasse, Hannover, Germany
  • 4St. Josefshospital, Offenburg, Germany
  • 5Leberarztpraxis, Hannover, Germany
  • 6Internistische Facharztpraxis, Ulm, Germany
  • 7Gastroenterologische Facharztpraxis, Göttingen, Germany
  • 8Internistische Facharztpraxis, Berlin, Germany
  • 9Praxiszentrum Kaiserdamm, Berlin, Germany
  • 10St. Marienhospital, Vechta, Germany
  • 11Klinikum der Universität München, München, Germany
  • 12MSD Pharma GmbH, Haar, Germany

Aims: Many patients (pts) with chronic liver disease are asymptomatic or may have nonspecific symptoms such as fatigue in the absence of hepatic synthetic dysfunction. Information regarding the presentation of chronic liver disease in Germany is still scarce. We investigated the frequency of asymptomatic and symptomatic presentations of chronic liver disease according to HCV status, gender and age.

Methods: Based on ALT/AST Screening between 12/2008 and 12/2010, 3161 pts with elevated liver enzymes were identified by 19 German hospitals and gastroenterological practices. Clinical presentations by symptoms (e.g. fatigue, pruritus) were retrospectively analyzed by gender, age and HCV status. Only pts with information on HCV status were included. Patients with liver cirrhosis were excluded from the analysis.

Results: Of 2400 pts with chronic liver disease N=1018 had chronic HCV infection while N=1382 suffered from HCV-negative chronic liver disease (NASH: N=699; alcohol: N=157; hepatitis B: N=143; autoimmune: N=80; PBC/PSC: N=62; genetic/metabolic: N=105; other: N=136). Liver disease was asymptomatic in 42.7% and 43.4% of pts with/without HCV and declined from 45.3% and 47.7% to 37.1% (p=0.013) and 31.9% (p<0.0001) in patients ≤50 years/>50 years. Fatigue was the most common symptom in both groups with a higher frequency of 49% compared to 34.7% in pts with/without HCV (p<0.001) and increased only slightly with increasing age from 46.7% and 35.8% (≤50 years) to 54.4% (p=0.02) and 40.6% (>50 years; p=0.10). In contrast, pts without HCV showed a 2-fold higher frequency of abdominal pain/discomfort (26.4%) compared to HCV pts (13.2%, p<0.0001) with a maximum of 34.2% in pts >50 years. In both groups the frequency of above symptoms together with pruritus and weak concentration did not differ between females and males while arthralgia was more frequent in females than in males with HCV infection (6.5% vs. 2.9%, p<0.01).

Conclusions: The present study demonstrates a high frequency (>40%) of asymptomatic chronic liver disease in the German population. The frequency of symptoms seems to be determined by etiology of liver disease and age rather than by gender. Our results confirm a particularly high prevalence of fatigue in pts with chronic HCV infection.

Alle über einen Kamm? Die Bedeutung von Alter und Geschlecht bei GI-Erkrankungen
Freitag, 21. September 2012/15:30–17:00/Saal 7