title: Prevalence in vulnerable population of liver fibrosis identified by transient elastography.
abstract: BACKGROUND
  Transient elastography (TE) is a useful tool for the assessment of hepatic fibrosis as an alternative to liver biopsy, but it has not been validated as a screening procedure in apparently healthy people.
  
  
  OBJECTIVE
  To determine the prevalence of advanced liver fibrosis diagnosed by TE in a socioeconomically challenged rural population.
  
  
  METHODS
  We enrolled 299 participants aged over 18 years old from a vulnerable population in Mexico who responded to an open invitation. All participants had their history recorded and underwent a general clinical examination and a liver stiffness measurement, performed by a single operator according to international standards.
  
  
  RESULTS
  Overall, 7.35% participants were found to be at high risk for cirrhosis. Three variables correlated with a risk for a TE measure ≥ 9 kPa and significant fibrosis: history of alcohol intake [7.95 vs. 92.04%, odds ratio (OR) 4.47, 95% confidence interval (CI) 1.45-13.78, P = 0.0167], body mass index (BMI) ≥ 30 kg/m2 (30.87 vs. 69.12%, OR 4.25, 95%CI 1.04-6.10, P = 0.049), and history of diabetes mellitus (14.87 vs. 85.12%, OR 2.76, 95%CI 1.002-7.63, P = 0.0419). In the multivariate analyses BMI ≥ 30 kg/m2 was the only significant risk factor for advanced liver fibrosis or cirrhosis (OR 2.54, 95%CI 1.02-6.3, P = 0.0460).
  
  
  CONCLUSIONS
  TE could be useful as a screening process to identify advanced liver fibrosis in the general and apparently healthy population.
authors.affiliation: Obesity and Digestive Diseases Unit Mexico.
authors.forename: Norberto
authors.initials: N
authors.lastname: Chávez-Tapia
authors.affiliation: Obesity and Digestive Diseases Unit Mexico.
authors.forename: Jorge
authors.initials: J
authors.lastname: Torres-Sánchez
authors.affiliation: Obesity and Digestive Diseases Unit Mexico.
authors.forename: Juan
authors.initials: J
authors.lastname: Romero-Flores
authors.affiliation: Obesity and Digestive Diseases Unit Mexico.
authors.forename: Paulina
authors.initials: P
authors.lastname: Álvarez-Quiroz
authors.affiliation: Obesity and Digestive Diseases Unit Mexico.
authors.forename: Sandra
authors.initials: S
authors.lastname: Ramírez-Álvarez
authors.affiliation: Obesity and Digestive Diseases Unit Mexico.
authors.forename: Eva
authors.initials: E
authors.lastname: Juárez-Hernández
authors.affiliation: Clinical Laboratory Mexico.
authors.forename: José
authors.initials: J
authors.lastname: Pérez-Jáuregui
authors.affiliation: Liver Unit. Medica Sur Clinic & Foundation. Mexico City.
authors.forename: Nahum
authors.initials: N
authors.lastname: Méndez-Sánchez
authors.affiliation: Liver Unit. Medica Sur Clinic & Foundation. Mexico City.
authors.forename: Misael
authors.initials: M
authors.lastname: Uribe
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D016009:Chi-Square Distribution; D015897:Comorbidity; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D012424:Rural Population; D012959:Socioeconomic Factors; D035862:Vulnerable Populations