Prevalence of the most common external manifestations and comorbidities in men with decompensated alcoholic liver cirrhosis
Abstract
Background/Aim. External manifestations and comorbidities represent important clinical aspects of decompensated alcoholic liver cirrhosis (ALC), providing insight into disease severity and systemic involvement. The aim of the study was to examine the prevalence of external signs and comorbidities in male patients with decompensated ALC. Methods. A prospective, comparative, descriptive, and analytical study was conducted at the Clinic for Internal Medicine, University Clinical Center of the Republic of Srpska, in Banja Luka, Bosnia and Herzegovina. The study included 123 male patients diagnosed with decompensated ALC. All necessary diagnostic evaluations, including laboratory, microbiological, serological, radiological, and endoscopic assessments, were performed during their first hospitalization. Results. The mean age of the patients was 59.09 ± 9.32 years. The most common external manifestations were jaundice (79.67%), spider nevi (54.47%), palmar erythema (36.58%), and gynecomastia (18.69%). The most frequent comorbidities were diabetes mellitus (19.51%), congestive heart failure (17.88%), and chronic kidney disease (11.38%). A significant correlation was found between disease severity and the presence of external signs, with jaundice being the most prevalent. Conclusion. External manifestations and comorbidities are frequent in male patients with ALC, reflecting the systemic impact of the disease. Recognizing these clinical markers can aid in early diagnosis, risk stratification, and tailored therapeutic strategies.
References
World Population Review. Alcohol consumption by country 2025 [Internet]. Lancaster: WPR; 2025 (accessed 2025 April 28). Available from: https://worldpopulationreview.com/country-rankings/alcohol-consumption-by-country
World Health Organization. Over 3 million annual deaths due to alcohol and drug use, majority among men [Internet]. Geneva: WHO; 2024 (accessed 2025 April 28). Available from: https://www.who.int/news/item/25-06-2024-over-3-million-annual-deaths-due-to-alcohol-and-drug-use-majority-among-m
en
Niu X, Zhu L, Xu Y, Zhang M, Hao Y, Ma L, et al. Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis. BMC Public Health 2023; 23(1): 859. Erratum in: BMC Public Health 2023; 23(1): 1380.
Osna NA, Donohue TM Jr, Kharbanda KK. Alcoholic Liver Disease: Pathogenesis and Current Management. Alcohol Res 2017; 38(2): 147−61.
Julien J, Ayer T, Tapper EB, Chhatwal J. The Rising Costs of Alcohol-Associated Liver Disease in the United States. Am J Gastroenterol 2024; 119(2): 270−7.
Devarbhavi H, Asrani SK, Arab JP, Nartey YA, Pose E, Kamath PS. Global burden of liver disease: 2023 update. J Hepatol 2023; 79(2): 516−37.
Roerecke M, Vafaei A, Hasan OSM, Chrystoja BR, Cruz M, Lee R, et al. Alcohol Consumption and Risk of Liver Cirrhosis: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2019; 114(10): 1574−86.
Patel R, Mueller M. Alcohol-Associated Liver Disease [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 (accessed 2025 April 28). Available from: https://www.ncbi.nlm.nih.
gov/books/NBK546632/
Liu Y, Zhao Y, Gao X, Liu J, Ji F, Hsu YC, et al. Recognizing skin conditions in patients with cirrhosis: a narrative review. Ann Med 2022; 54(1): 3017−29.
Bhandari A, Mahajan R. Skin Changes in Cirrhosis. J Clin Exp Hepatol 2022; 12(4): 1215−24.
Tapper EB, Parikh ND. Diagnosis and Management of Cirrhosis and Its Complications: A Review. JAMA 2023; 329(18): 1589−602.
García-Compeán D, Orsi E, Kumar R, Gundling F, Nishida T, Villarreal-Pérez JZ, et al. Clinical implications of diabetes in chronic liver disease: Diagnosis, outcomes and management, current and future perspectives. World J Gastroenterol 2022; 28(8): 775−93.
Dugum M, McCullough A. Diagnosis and Management of Alcoholic Liver Disease. J Clin Transl Hepatol 2015; 3(2): 109−16.
Mirowski K, Balicka-Ślusarczyk B, Hydzik P, Zwolińska-Wcisło M. Alcohol-associated liver disease - a current overview. Folia Med Cracov 2024; 64(2): 93−104.
Liu YB, Chen MK. Epidemiology of liver cirrhosis and associated complications: Current knowledge and future directions. World J Gastroenterol 2022; 28(41): 5910−30.
Bokan G, Kovacevic M, Zdravkovic N, Bokonjic D, Kovacevic M, Prodanovic V, et al. Significance of Laboratory Findings and Esophageal Varices in Male Patients With Decompensated Alcoholic Liver Cirrhosis: A Single-Center Experience. Cureus 2025; 17(1): e78274.
Sharma P, Arora A. Clinical presentation of alcoholic liver disease and non-alcoholic fatty liver disease: spectrum and diagnosis. Transl Gastroenterol Hepatol 2020; 5: 19.
Ray G, Manjubhargav P. Clinical Presentation and Mortality Determinants of Alcohol-Related Liver Disease: A Single-Center Experience of the Rising Menace from Eastern India. Inflamm Intest Dis 2019; 4(3): 104−14.
Heidelbaugh JJ, Bruderly M. Cirrhosis and chronic liver failure: part I. Diagnosis and evaluation. Am Fam Physician 2006; 74(5): 756−62.
Nilsson E, Anderson H, Sargenti K, Lindgren S, Prytz H. Incidence, clinical presentation and mortality of liver cirrhosis in Southern Sweden: a 10-year population-based study. Aliment Pharmacol Ther 2016; 43(12): 1330−9.
Adachi M, Brenner DA. Clinical syndromes of alcoholic liver disease. Dig Dis 2005; 23(3−4): 255−63.
Li H, Wang R, Méndez-Sánchez N, Peng Y, Guo X, Qi X. Impact of spider nevus and subcutaneous collateral vessel of chest/abdominal wall on outcomes of liver cirrhosis. Arch Med Sci 2019; 15(2): 434−48.
Coman LI, Coman OA, Bădărău IA, Păunescu H, Ciocîrlan M. Association between Liver Cirrhosis and Diabetes Mellitus: A Review on Hepatic Outcomes. J Clin Med 2021; 10(2): 262.
Milić S, Lulić D, Štimac D, Ružić A, Zaputović L. Cardiac manifestations in alcoholic liver disease. Postgrad Med J 2016; 92(1086): 235−9.