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Epidemiological Correlates of Impaired Liver Function in Taiwan, an Area Endemic for Chronic Liver Disease
並列摘要
Background: To determine the prevalence and etiology of impaired liver function among Taiwanese. Methods: A cross-sectional study was carried out in 7 townships for 11,251 men aged 30-64 years. Blood specimens were tested for serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels and for the presence of hepatitis B surface antigen (HBsAg) and antibodies to hepatitis C virus (anti-HCV). In addition, hepatitis B e antigen (HBeAg) was tested for the HBsAg-positive individuals. Histories of alcohol consumption and cigarette smoking were collected from participants using in-person questionnaires. Univariate analysis and multiple logistic regression analysis were conducted to determine the epidemiological correlates for impaired liver function, as defined by a combination of an ALT level of ≧45 IU/L and an AST level of ≧40 IU/L. Results: The prevalence of impaired liver function was 2.6% (95% confidence interval [CI], 2.3%-2.9%). Multiple logistic regression analysis showed that acquisition of HCV infection (adjusted odds ratio [OR], 13.5; 95% CI, 9.8-18.6) and active replication of HBV in HBsAg carriers (OR, 10.7; 95% CI, 7.3-15.7) were the predominant factors for an increased risk of impaired liver function. There was a significant additive interaction between HCV infection and a history of alcohol intake and cigarette smoking, for the risk of impaired liver function. Conclusions: Hepatitis C and hepatitis B virus infections were the dominant factors that signaled the risk of liver injury. In addition, the presence of HCV showed an additive synergistic effect for alcohol- and smoking-related impaired liver function among these Taiwanese.
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