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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2014, Número 5

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Rev Invest Clin 2014; 66 (5)


Asociación de esteatosis hepática con factores de riesgo cardiovascular y aterosclerosis subclínica en población mexicana

Martínez-Alvarado MR, Juárez-Rojas JG, Medina-Urrutia AX, Cardoso-Saldaña GC, González-Salazar MC, Posadas-Sánchez R, Jorge-Galarza E, Mendoza-Pérez E, Vargas-Alarcón G, Posadas-Romero C

Idioma: Ingles.
Referencias bibliográficas: 37
Paginas: 407-414
Archivo PDF: 157.83 Kb.


RESUMEN

Introducción. Los sujetos con esteatosis hepática (EH) tienen riesgo incrementado de enfermedad arterial coronaria (EAC), probablemente debido a su asociación con factores de riesgo cardiometabólico (FRC). Objetivo. En una muestra de población mestiza mexicana, conocer la prevalencia de EH y analizar su asociación con FRC y con aterosclerosis subclínica. Material y métodos. Se incluyeron 846 sujetos participantes del estudio Genética de la Enfermedad Aterosclerosa (53 ±9 años, 50.7% mujeres), sin diabetes y sin antecedentes personales ni familiares de EAC prematura. En sangre se midieron perfil de lípidos, ácido úrico e insulina. Por tomografía axial computarizada (TAC) se identificó la presencia de EH. El grosor de íntima media (GIM) carotídeo se midió por ultrasonido, utilizando la percentila 75 como punto de corte para definir aterosclerosis subclínica. Resultados. La prevalencia general de EH fue de 32.4%. En los hombres la EH se asoció con hiperuricemia; mientras que en las mujeres, la hiperuricemia, los valores bajos de colesterol de lipoproteínas de alta densidad y el síndrome metabólico fueron los factores asociados a esta alteración hepática. En el sexo femenino la EH se asoció con una probabilidad 66% mayor de tener GIM elevado, independientemente de la edad, hipertensión, dislipidemia y circunferencia de cintura, pero no del HOMA-RI. Conclusiones. En las mujeres la EH se asoció con la presencia de aterosclerosis subclínica, independientemente de los FRC tradicionales. Nuestro estudio sugiere que en mujeres, la resistencia a la insulina pudiera ser mediadora de las anormalidades metabólicas y de la aterosclerosis subclínica.


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