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This study systematically explored the independent impact of patient characteristics, portal hypertension and hepatic dysfunction on PHG severity and associated anemia.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients with cirrhosis undergoing endoscopy were included in this retrospective analysis and PHG was endoscopically graded as absent, mild or severe. Clinical and laboratory parameters and hepatic venous pressure gradient (HVPG) were assessed with respect to an association with severity of PHG.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 110 patients (mean age: 57\u00a0years, 69% male) with mostly alcoholic liver disease (49%) or viral hepatitis (30%) were included: 15 (13.6%) patients had no PHG, 59 (53.6%) had mild PHG, and 36 (32.7%) had severe PHG. Severe PHG was significantly associated with male sex (83.3% vs. 62.2% in no or mild PHG; <jats:italic>p<\/jats:italic>\u202f=\u20090.024) and higher Child-Turcotte-Pugh (CTP) stage (CTP-C: 38.9% vs. 27.0% in no or mild PHG; <jats:italic>p<\/jats:italic>\u202f=\u20090.030), while MELD was similar (<jats:italic>p<\/jats:italic>\u202f=\u20090.253). Patients with severe PHG had significantly lower hemoglobin values (11.2\u202f\u00b1\u20090.4\u202fg\/dL vs. 12.4\u202f\u00b1\u20090.2\u202fg\/dL; <jats:italic>p<\/jats:italic>\u202f=\u20090.008) and a\u00a0higher prevalence of iron-deficiency anemia (IDA: 48.5% vs. 26.9%; <jats:italic>p<\/jats:italic>\u202f=\u20090.032). Interestingly, HVPG was not significantly higher in severe PHG (median 20\u202fmm\u202fHg) vs. mild PHG (19\u202fmm\u202fHg) and no PHG (18\u202fmm\u202fHg; <jats:italic>p<\/jats:italic>\u202f=\u20090.252). On multivariate analysis, CTP score (odds ratio, OR: 1.25, 95% confidence interval, CI 1.02\u20131.53; <jats:italic>p<\/jats:italic>\u202f=\u20090.033) was independently associated with severe PHG, while only a\u00a0trend towards an independent association with IDA was observed (OR: 2.28, 95% CI 0.91\u20135.72; <jats:italic>p<\/jats:italic>\u202f=\u20090.078).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The CTP score but not HVPG or MELD were risk factors for severe PHG. Importantly, anemia and especially IDA are significantly more common in patients with severe PHG.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00508-019-01593-w","type":"journal-article","created":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T09:04:00Z","timestamp":1578387840000},"page":"1-11","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Portal hypertensive gastropathy is associated with iron deficiency anemia"],"prefix":"10.1007","volume":"132","author":[{"given":"Benedikt","family":"Simbrunner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Beer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"W\u00f6ran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Schmitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Primas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Wewalka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Pinter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Dolak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Scheiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Puespoek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Trauner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Oberhuber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Mandorfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-3583","authenticated-orcid":false,"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,7]]},"reference":[{"issue":"3","key":"1593_CR1","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.jhep.2015.05.022","volume":"63","author":"R de Franchis","year":"2015","unstructured":"de Franchis\u00a0R. 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M.\u00a0Pinter is an investigator for Bayer, BMS, and Lilly, he received speaker fees from Bayer, BMS, Eisai, and MSD, he is a\u00a0consultant for Bayer, BMS, Ipsen, Eisai, and Lilly, and he received travel support from Bayer and BMS. B.\u00a0Scheiner received travel support from Abbvie and Gilead. M.\u00a0Trauner received speaker fees from BMS, Falk Foundation, Gilead and MSD; advisory board fees from Albireo, Falk Pharma GmbH, Genfit, Gilead, Intercept, MSD, Novartis, Phenex and Regulus. He further received travel grants from Abbvie, Falk, Gilead and Intercept and unrestricted research grants from Albireo, Cymabay, Falk, Gilead, Intercept, MSD and Takeda. M.\u00a0Mandorfer has served as a\u00a0speaker and\/or consultant and\/or advisory board member for AbbVie, Bristol-Myers Squibb, Gilead, W.\u00a0L.\u00a0Gore & Associates and Janssen. T.\u00a0Reiberger received grant support from Abbvie, Boehringer-Ingelheim, Gilead, MSD, Philips Healthcare, Gore; speakers fees from Abbvie, Gilead, Gore, Intercept, Roche, MSD; consulting\/advisory board fee from Abbvie, Bayer, Boehringer-Ingelheim, Gilead, MSD, Siemens and travel support from Boehringer-Ingelheim, Gilead and Roche. A.\u00a0Beer, K.\u00a0W\u00f6ran, F.\u00a0Schmitz, C.\u00a0Primas, M.\u00a0Wewalka, W.\u00a0Dolak, A. Puespoek and G.\u00a0Oberhuber declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee (Medical University of Vienna (EK1016\/2017)) and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. The need for a specific informed consent for this retrospective analysis was waived by the Ethics committee of the Medical University of Vienna, since all procedures and tests were performed in clinical routine and only anonymized data are reported.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}