{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T23:05:52Z","timestamp":1765667152906},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T00:00:00Z","timestamp":1463443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Liver\u2010related mortality varies across developed nations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the relative role of various risk factors in relation to liver\u2010related mortality in an ecological study approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data for liver\u2010related mortality, prevalence data for hepatitis B and C, human immunodeficiency virus (<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>), alcohol consumption per capita, Type 2 Diabetes mellitus (T2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>), overweight and obesity were extracted from peer\u2010reviewed publications or <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content> databases for different developed countries. As potential other risk\u2010modifying factors, purchase power parity (<jats:styled-content style=\"fixed-case\">PPP<\/jats:styled-content>)\u2010adjusted gross domestic product (<jats:styled-content style=\"fixed-case\">GDP<\/jats:styled-content>) per capita and health expenditure per capita were assessed. As an environmental \u2018hygiene factor\u2019, we also assessed the effect of the prevalence of <jats:italic>Helicobacter pylori<\/jats:italic>. Only countries with a <jats:styled-content style=\"fixed-case\">PPP<\/jats:styled-content>\u2010adjusted <jats:styled-content style=\"fixed-case\">GDP<\/jats:styled-content> greater than $20 000 and valid information for at least 8 risk modifiers were included. Univariate and multivariate analyses were utilised to quantify the contribution to the variability in liver\u2010related mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of chronic liver diseases (<jats:styled-content style=\"fixed-case\">CLD<\/jats:styled-content>)\u2010related mortality ranged from 0.73\u20132.40% [mean 1.56%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> (1.43\u20131.69)] of all deaths. Univariately, <jats:styled-content style=\"fixed-case\">CLD<\/jats:styled-content>\u2010related mortality was significantly associated with Hepatitis B prevalence, alcohol consumption, <jats:styled-content style=\"fixed-case\">PPP<\/jats:styled-content>\u2010adjusted <jats:styled-content style=\"fixed-case\">GDP<\/jats:styled-content> (all <jats:italic>P<\/jats:italic> &lt; 0.05) and potentially <jats:italic>H. pylori<\/jats:italic> prevalence (<jats:italic>P<\/jats:italic> = 0.055). Other investigated factors, including hepatitis C, did not yield significance. Backward elimination suggested hepatitis B, alcohol consumption and <jats:styled-content style=\"fixed-case\">PPP<\/jats:styled-content>\u2010adjusted <jats:styled-content style=\"fixed-case\">GDP<\/jats:styled-content> as risk factors (explaining 66.3% of the variability).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hepatitis B infection, alcohol consumption and <jats:styled-content style=\"fixed-case\">GDP<\/jats:styled-content>, but not hepatitis C or other factors, explain most of the variance of liver\u2010related mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13657","type":"journal-article","created":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T03:40:55Z","timestamp":1463542855000},"page":"68-77","source":"Crossref","is-referenced-by-count":8,"title":["Liver\u2010related mortality in countries of the developed world: an ecological study approach to explain the variability"],"prefix":"10.1111","volume":"44","author":[{"given":"M.","family":"von Wulffen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane Qld Australia"},{"name":"Faculty of Medicine and Biomedical Sciences University of Queensland Brisbane Qld Australia"},{"name":"Translational Research Institute Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. J.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane Qld Australia"},{"name":"Faculty of Medicine and Biomedical Sciences University of Queensland Brisbane Qld Australia"},{"name":"Cancer Control Unit Berghofer\u2010QIMR Medical Research Institute Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. A.","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane Qld Australia"},{"name":"Faculty of Medicine and Biomedical Sciences University of Queensland Brisbane Qld Australia"},{"name":"Translational Research Institute Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. S.","family":"Raj","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane Qld Australia"},{"name":"Faculty of Medicine and Biomedical Sciences University of Queensland Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. J.","family":"Kendall","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane Qld Australia"},{"name":"Faculty of Medicine and Biomedical Sciences University of Queensland Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. 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