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Méndez-Sánchez N, Cerda-Reyes E, Higuera-de-la-Tijera F, Salas-García AK, Cabrera-Palma S, Cabrera-Álvarez G, Cortez-Hernández C, Pérez-Arredondo LA, Purón-González E, Coronado-Alejandro E, Panduro A, Rodríguez-Hernández H, Cruz-Ramón VC, Valencia-Rodríguez A, Qi X, Hamdan-Pérez N, Aguilar-Olivos NE, Barranco-Fragoso B, Ramírez-Pérez O, Vera-Barajas A. Dyslipidemia as a risk factor for liver fibrosis progression in a multicentric population with non-alcoholic steatohepatitis. F1000Res 2020; 9:56. [PMID: 32595949 PMCID: PMC7308903 DOI: 10.12688/f1000research.21918.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2020] [Indexed: 02/05/2023] Open
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is a serious worldwide health problem, with an estimated global prevalence of 24%; it has a notable relationship with other metabolic disorders, like obesity and type 2 diabetes mellitus (T2DM). Nonalcoholic steatohepatitis (NASH) is one of the most important clinical entities of NAFLD, which is associated with an increased risk of progression to liver cirrhosis and hepatocellular carcinoma (HCC). Mexico is one of the countries with the highest prevalence of metabolic diseases; therefore, we sought to investigate the impact that these clinical entities have in the progression to advanced fibrosis in Mexican patients with NASH. Methods: We performed a multicenter retrospective cross-sectional study, from January 2012 to December 2017. A total of 215 patients with biopsy-proven NASH and fibrosis were enrolled. NASH was diagnosed according NAS score and liver fibrosis was staged by the Kleiner scoring system. For comparing the risk of liver fibrosis progression, we divided our sample into two groups. Those patients with stage F0-F2 liver fibrosis were included in the group with non-significant liver fibrosis (n=178) and those individuals with F3-F4 fibrosis were included in the significant fibrosis group (n=37). We carried out a multivariate analysis to find risk factors associated with liver fibrosis progression. Results: From the 215 patients included, 37 had significant liver fibrosis (F3-4). After logistic regression analysis T2DM (p=0.044), systemic arterial hypertension (p=0.014), cholesterol (p=0.041) and triglycerides (p=0.015) were the main predictor of advanced liver fibrosis. Conclusions: In a Mexican population, dyslipidemia was the most important risk factor associated with advanced liver fibrosis and cirrhosis.
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Affiliation(s)
- Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico, 14050, Mexico
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Eira Cerda-Reyes
- Department of Gastroenterology, Central Military Hospital, Mexico City, Mexico
| | - Fátima Higuera-de-la-Tijera
- Department of Gastroenterology, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico, Mexico
| | - Ana K. Salas-García
- Department of Gastroenterology, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico, Mexico
| | | | | | - Carlos Cortez-Hernández
- Department of Gastroenterology, University Hospital “Jose Eleuterio González”, Monterrey, Nuevo Leon, Mexico
| | - Luis A Pérez-Arredondo
- Department of Gastroenterology, University Hospital “Jose Eleuterio González”, Monterrey, Nuevo Leon, Mexico
| | - Emma Purón-González
- Department of Internal Medicine, Christus Muguerza “Super Specialty Hospital”, Monterrey, Nuevo Leon, Mexico
| | - Edgar Coronado-Alejandro
- Department of Internal Medicine, Christus Muguerza “Super Specialty Hospital”, Monterrey, Nuevo Leon, Mexico
| | - Arturo Panduro
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara "Fray Antonio Alcalde”, Guadalajara, Jalisco, Mexico
| | | | - Vania C. Cruz-Ramón
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico, 14050, Mexico
| | | | - Xingshun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 10016, China
| | - Nashla Hamdan-Pérez
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico, 14050, Mexico
| | | | - Beatriz Barranco-Fragoso
- Department of Gastroenterology, National Medical Center "20 Noviembre", Mexico City, Mexico, 03229, Mexico
| | - Oscar Ramírez-Pérez
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico, 14050, Mexico
| | - Alfonso Vera-Barajas
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico, 14050, Mexico
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