[Frequency of NAFLD in a group of patients with metabolic syndrome in Veracruz, Mexico].
BACKGROUND
Nonalcoholic fatty liver disease is a very common disease that is being described principally in obese, diabetic and hiperlipidemic patients without significant alcohol consumption (less than 28 ethanol Units per week). Nowadays it is considered as the hepatic manifestation of the metabolic syndrome. The frequency of Non Alcoholic Sreatohepatic (NASH) is 30 to 35% in general population, but it reaches to 70% in patients whose Body Mass Index (BMI) is above 30 kg/m2 as it occurs with diabetic patients. In Mexico there are only isolated reports about it's frequency, nearly 7.1% in general population and 18.5% in diabetic patients.


OBJECTIVE
To know the frequency of the Nonalcoholic fatty liver disease in patients who receive medical attention at the city of Veracruz.


METHODS
We studied 337 patients, who were divided into 4 groups: Normal Weight, Overweight, Obese and Diabetes type 2 patients. The individuals who reported previous hepatitis and alcohol consumption were excluded. All patients made a test in order to determinate: age, gender, presence of hepatic stigmata and complaints. Laboratory tests were done to all patients including: Blood glucose, seric lipids, transaminases, proteins and alkaline phosphatase. In those cases with impairment in transaminases results, it was done upper abdominal ultrasound (USG) and hepatic biopsy, in patients who accepted.


RESULTS
We identified 53 cases (15.72%) with characteristics of Nonalcoholic fatty liver disease. The frequency in patient with normal weight and overweight was 7.14% to 7.76%, while in obese subjects it was 14.15% and 28% in diabetic patients; 73.58% of all patients were female and the other 28.41% were males. The average age of the group was 48.11 years, it was similar the specific age of the normal weight and obese patients, in overweight patients was 61.5 years and the average age in diabetics was 56.42 years. There were significant differences in the results of blood glucose level, glycosilated hemoglobin, cholesterol, seric lipid values and aminotransferases in obese and diabetic patients compared with normal subjects and overweight patients in our study, the USG did not show sensibility and specificity to detect Non alcoholic fatty liver disease (NAFLD).


CONCLUSIONS
The results of this study show a lower frequency compared with the rest of the world, however it was higher in diabetic population than the frequency published by Bernal in Hidalgo, Mexico. The aminotransferases level resulted elevated in all patients with metabolic syndrome and NAFLD so we consider that elevated aminotransferases levels is the best predictor to suspect the presence of NAFLD. That is why it's very important to consider the possibility to avoid the progression to cirrhosis and hepatocarcinoma.
Roesch-Dietlen
Federico
F
Instituto de Investigaciones Médico-Biológicas de la Universidad Veracruzana. federicoroesch@uv.com
Dorantes-Cuéllar
Alicia
A
Carrillo-Toledo
Maria Graciela
MG
Martínez-Sibaja
Cristina
C
Rojas-Carrera
Sonia
S
Bonilla-Rojas
Q C Sashenka
QC
Uchino-Higueras
Virginia
V
Lagunas
Teresa
T
Carrasco-Arróniz
Miguel Angel
MA
Soler-Leal
Bertha
B
León-Valdivieso
Johnatan
J
Cid-Juárez
Silvia
S
Martínez
José Angel
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D014463:Ultrasonography