title: The relationship of overweight and obesity to high mortality rates from liver cirrhosis in Mexico.
abstract: OBJECTIVE
  Liver cirrhosis continues to be an important cause of death in Mexico. Some data suggest that being overweight is a risk factor for chronic liver disease. The aim of this study was to assess the link between the incidences of being overweight or obese and mortality from liver cirrhosis in Mexico during the period 1990-2001.
  
  
  METHODS
  We designed and conducted an ecological study of trends with multiple comparisons of regions of Mexico (North, Central, Mexico City, and South). We built the time trends according to the mortality rates of liver cirrhosis reported by the System of Vital Statistics (Health Ministry) in each state for each year from 1990 to 2001. The information on prevalences of overweight (body mass index (BMI) = 25-29.9) and obesity (BMI >/= 30) was from two national surveys (1993 and 2000).
  
  
  RESULTS
  The analysis of mortality trends in liver cirrhosis by region showed an increase in the risk of death across time. This risk was considerably higher for the South Region (beta = 1.03, p <0.0001). The mortality rates remained higher than 30 per 100,000 inhabitants. When we selected the three states with the highest mortality rates for each region, the most significant changes in the trends were in the North and South regions (beta = 0.75, p <0.0001 and beta = 1.29, p <0.0001, respectively). In addition, the prevalence of overweight in the four regions increased from 1993 to 2000 (percentage change, 10.2-48.2). Obesity was most prevalent in the North and South regions in 1993.
  
  
  CONCLUSIONS
  Our observations support the hypothesis that obesity might play an important role in the risk of developing liver cirrhosis.
authors.affiliation: Departments of Biomedical Research and Gastroenterology and Liver Unit. Medica Sur Clinic & Foundation. Mexico City, Mexico. nmendez@medicasur.org.mx
authors.forename: Nahum
authors.initials: N
authors.lastname: Méndez-Sánchez
authors.forename: Claudia P
authors.initials: CP
authors.lastname: Sánchez-Castillo
authors.forename: Antonio R
authors.initials: AR
authors.lastname: Villa
authors.forename: Herlinda
authors.initials: H
authors.lastname: Madrigal
authors.forename: Beatriz
authors.initials: B
authors.lastname: Merino
authors.forename: Elsy
authors.initials: E
authors.lastname: García
authors.forename: Patricia
authors.initials: P
authors.lastname: López
authors.forename: Edgar
authors.initials: E
authors.lastname: Pichardo-Ontiveros
authors.forename: Misael
authors.initials: M
authors.lastname: Uribe
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015430:Weight Gain