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2005, Number 1

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Gac Med Mex 2005; 141 (1)

Prevalence of non-alcoholic esteatohepatitis in adults with metabolic syndrome in Oaxaca

Álvarez-Martínez HE, Pérez-Campos E, Leyva-Bohórquez P

Language: Spanish
References: 38
Page: 7-12
PDF size: 58.48 Kb.


ABSTRACT

Nonalcoholic steatohepatitis (NASH) is a chronic liver disease that occurs in patients with no significant alcohol consumption, characterized for macrovesicular steatosis, hepatocellular necrosis, mixed inflammatory infiltrate and various grades of fibrosis and, in some cases, Mallory bodies. The prevalence of this disease is unknown; recent studies indicate that in the general population, incidence is about 3%, although the rates are higher in some subpopulations as are obesity and diabetes mellitus. The goal of this work was to determine the prevalence of non-alcoholic steatohepatitis in one sample of patients with the metabolic syndrome, patients at ”Presidente Juárez” Regional Hospital. It was a cross-sectional and descriptive study in which, by means of random selection a sample of 110 patients with type 2 diabetes mellitus, arterial hypertension, obesity and dyslipidemia, alone or in combination was chosen. We carried out a clinical and laboratory evaluation, selecting those patients with persistent elevation of aminotransferases for whom additional studies were made, in order to exclude other causes of enzyme abnormality. Five patients were selected for percutaneous liver biopsy, all they had NASH. The prevalence of NASH was 4.54%. The clinical and laboratory characteristics of these patients will be discussed in the article.


REFERENCES

  1. Brunt EM. Nonalcoholic steatohepatitis: definition and pathology. Semin Liver Dis 2001;21:3-16.

  2. Ramrakhiani S, Bacon BR. Hepatology in the new millennium. Med Clin North Am 2000; 84:1085-105.

  3. Adler M, Schaffner F. Fatty liver hepatitis and cirrhosis in obese patients. Am J Med 1979;67:811-6.

  4. Ludwig J, Viggiano TR, McGill DB, Oh BJ. Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc 1980;55: 434-8.

  5. Powell EE, Cooksley WG, Hanson R, Searle J, Halliday JW, Powell LW. The natural history of nonalcoholic steatohepatitis: a follow-up study of forty-two patients for up to 21 years. Hepatology 1990;11:74-80.

  6. Poonawala A, Nair SP, Thuluvath PJ. Prevalence of obesity and diabetes in patients with cryptogenic cirrhosis: a case-control study. Hepatology 2000;32:689-92.

  7. Sheth SG, Gordon FD, Chopra S. Nonalcoholic steatohepatitis. Ann Intern Med 1997;126:137-45.

  8. Bacon BR, Farahvash MJ, Janney CG, Neuschwander-Tetri BA. Nonalcoholic steatohepatitis: an expanded clinical entity. Gastroenterology, 1994;107:1103-9.

  9. Badalamenti S, Kligerman S, Molina E, Jeffers L, Reddy R, Schiff E. Clinical features commonly associated with fatty liver/non-alcoholic steatohepatitis (NASH). Hepatology 1998;28:385A.

  10. Teli MR, James OF, Burt AD, Bennett MK, Day CP. The natural history of nonalcoholic fatty liver: a follow up study. Hepatology 1995;22:1714-9.

  11. Kumar KS, Malet PF. Nonalcoholic steatohepatitis. Mayo Clin Proc 2000;75:733-9.

  12. Falck-Ytter Y, Younossi ZM, Marchesini G, McCullough AJ. Clinical features and natural history of nonalcoholic steatosis syndromes. Semin Liver Dis 2001;21:17-26.

  13. Bernal-Reyes R, Saenz-Labra A, Bernardo-Escudero R. Prevalencia de la esteatohepatitis no alcohólica (EHNA). Estudio comparativo con diabéticos. Rev Gastroenterol Mex, 2000;65:58-62.

  14. Sepulveda-Flores RN, Vera-Cabrera L, Flores-Gutierrez JP, Maldonado-Garza H, Salinas-Garza R, Zorrilla-Blanco P, et al. Obesity-related non alcoholic steatohepatitis and TGF-B1 serum levels in relation to morbid obesity. Ann Hepatol 2002;1:36-9.

  15. Reid AE. Nonalcoholic steatohepatitis. Gastroenterology 2001;121:710-23.

  16. Pratt DS, Kaplan MM. Evaluation of abnormal liver-enzyme results in asymptomatic patients. N Engl J Med 2000;342:1266-71.

  17. Galambos JT, Wills CE. Relationship between 505 paired liver tests and biopsies in 242 obese patients. Gastroenterology 1978;74:1191-5.

  18. Sanyal AJ. Nonalcoholic steatohepatitis. Indian J Gastroenterol 2001;Suppl 1:C64-70.

  19. 19 Isselbacher KJ. Nonalcoholic steatohepatitis: importance of liver biopsy. Update to Chapter 299: Chung RT, Podolsky DK. Cirrhosis and its complications. En: Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL. eds. Harrison’s Principles of Internal Medicine 15th edition. New York. Mc Graw Hill; 2001.p.1754-67.

  20. Graif M, Yanuka M, Baraz M, Blank A, Moshkovitz M, Kessler A, et al. Quantitative estimation of attenuation in ultrasound video images: correlation with histology in diffuse liver disease. Invest Radiol 2000;35:319-24.

  21. Neuschwander-Tetri BA, Bacon BR. Nonalcoholic steatohepatitis. Med Clin North Am 1996;80:1147-66.

  22. Byrne T, Douglas DD, Harrison ME, Nelson L. Non-alcoholic steatohepatitis (NASH): is a liver biopsy necessary for diagnosis?. Hepatology 1997;26:388A.

  23. Sherlock S. Needle biopsy of the Liver. En: Diseases of the liver and biliary system. 6a Ed. Blackwell Scientific Publications:28-35.

  24. Dixon JB, Bhathal PS, O’Brien PE. Nonalcoholic fatty liver disease: predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese. Gastroenterology 2001;121:91-100.

  25. González ChA, Alexanderson RE, Alvarado RR, Ayub AM, Camacho AJ, Cardona MEG, et al. Consenso Mexicano de Resistencia a la Insulina y Síndrome Metabólico. Rev Mex Cardiol 1999;10:3-18.

  26. Powers AC. Diabetes mellitus. En: Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL. ed. Harrison’s Principles of Internal Medicine 15th edition. New York. Mc Graw Hill, 2001:2109-37.

  27. Joint National Committee, National High Blood Pressure Education Program: The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI): NIH Publication No. 98-4080. Bethesda, National Heart, Lung, and Blood Institute, National Institutes of Health, 1997.

  28. González BJ, Lara GJJ, Avila RH. Concepto, definición y diagnóstico. En: Vargas AL, Bastarrachea SR, Laviada MH, González BJ y Avila RH ed. Obesidad. Consenso. McGraw-Hill Interamericana; 2002. p.1-10.

  29. Hernández B, Velasco-Mondragón HE. Encuestas transversales. Salud Publica Mex 2000;42:447-55.

  30. Clark JM, Diehl AM. Defining nonalcoholic fatty liver disease: implications for epidemiologic studies. Gastroenterology 2003;124:248-50.

  31. Lavine JE. Vitamin E treatment of nonalcoholic steatohepatitis in children: a pilot study. J Pediatr 2000;136:734-8.

  32. Sanyal AJ, Campbell-Sargent C, Mirshahi F, Rizzo WB, Contos MJ, Sterling RK, et al. Nonalcoholic steatohepatitis: association of insulin resistance and mitochondrial abnormalities. Gastroenterology 2001;120:1183-92.

  33. Tankurt E, Biberoglu S, Ellidokuz E, Hekimsoy Z, Akpinar H, Comlekci A, et al. Hyperinsulinemia and insulin resistance in non-alcoholic steatohepatitis. J Hepatol 1999;31:963.

  34. Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, et al. Nonalcoholic fatty liver disease. a feature of the metabolic syndrome. Diabetes 2001;50:1844-50.

  35. Caldwell SH, Hespenheide EE, Redick JA, Iezzoni JC, Battle EH, Sheppard BL. A pilot study of a thiazolidinedione, troglitazone, in nonalcoholic steatohepatitis. Am J Gastroenterol 2001;96:519-25.

  36. Marchesini G, Brizi M, Bianchi G, Tomassetti S, Zoli M, Melchionda N. Metformin in non-alcoholic steatohepatitis. Lancet 2001;358:893-4.

  37. Chalasani N, Deeg MA, Persohn S, Crabb DW. Metabolic and anthropometric evaluation of insulin resistance in nondiabetic patients with nonalcoholic steatohepatitis. Am J Gastroenterol 2003;98:1849-55.

  38. Angulo P, Keach JC, Batts KP y Lindor KD. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatology 1999;30:1356-62.




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