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2019, Number 1

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Aten Fam 2019; 26 (1)

Obesity Relation with Non-alcoholic Hepatic Steatosis in a Family Medicine Unit

Garc�a PJ, Saavedra CVJ, G�mez AC, C�rdenas LA, Mendiola PIR, ; Chac�n VP

Language: Spanish
References: 34
Page: 8-12
PDF size: 141.04 Kb.


ABSTRACT

Objective: To analyze the relation between obesity and non-alcoholic hepatic steatosis in a Family Medicine Unit (fmu). Methods: analytical crosssectional study. The sample included 119 patients of both sexes, selected by a sampling for convenience, from 16 to 80 years, with no history of hepatic pathology, systemic chronic pathology, pregnancy or drug addiction, and who attended the fmu No. 75 in Morelia, Michoac�n, M�xico, from November 2016 to April 2017. Body mass index was calculated and laboratory studies were performed. Hepatic ultrasound was performed with which the diagnosis of non-alcoholic hepatic steatosis (nash) was established. The χ2 test was used for difference in proportions and anova test for difference of three or more averages. A p‹0.05 value was considered statistically significant. Results: 76 women and 43 men participated. 1.7% had low weight (n=2), 47.9% normal weight (n=57) and 50.4% overweight and obesity (n=60). 52.9% of the patients were diagnosed with nash (n=63). Overweight and obese patients showed a higher degree of nashcompared to those with a normal weight (P=0.000). Sedentary lifestyle patients showed a higher degree of nash compared to nonsedentary lifestyle (P=0.000). As greater degree of nash higher aspartate aminotransferase, alanine aminotransaminase and cholesterol values (P=0.000). Conclusion: Patients with overweight, obesity and sedentary lifestyle have a higher prevalence of non-alcoholic hepatic steatosis.


REFERENCES

  1. who. Global status report on noncommunicable diseases 2014 [Internet] [Citado 2018 abril 10]. Disponible en: http:// www.who.int/nmh/publications/ncd-status-report-2014/en/

  2. Andronescu CI, Purcarea MR, Babes PA. Nonalcoholic fatty liver disease: epidemiology, pathogenesis and therapeutic implications. J Med Life. 2018;11(1):20-3.

  3. Encuesta Nacional de Salud y Nutrici�n de Medio Camino 2016 [Internet] [Citado 2018 abril 25]. Disponible en: https://www.gob.mx/cms/uploads/attachment/file/209093/ ENSANUT.pdf

  4. Gu�a de pr�ctica cl�nica. Diagn�stico y Tratamiento de la Enfermedad Hep�tica Grasa No Alcoh�lica del Adulto [Internet] [Citado 2018 mayo 15]. Disponible en: http://www. cenetec.salud.gob.mx/descargas/gpc/CatalogoMaestro/719_ GPC_enfermedad_hepatica_grasa_no_alcoholica/719GRR. pdf

  5. Gu�a de pr�ctica cl�nica. Prevenci�n y diagn�stico de sobrepeso y obesidad en ni�os y adolescentes en el primer nivel de atenci�n [Internet] [Citado 2018 abril 18]. Disponible en: http://educads.salud.gob.mx/sitio/recursos/Sobrepeso%20 y%20Obesidad/ni%C3%B1os%20y%20adolescentes/ GPC%20UTILIZADAS/SS-025-08_GRR.pdf

  6. Targher G, Day C, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med. 2010;363(14):1341-50.

  7. Wabitsch M, Funcke J, Lennerz B, Kuhnle-Krahl U, Lahr G, Debatin K, et al. Biologically Inactive Leptin and Early- Onset Extreme Obesity. N Engl J Med. 2015;372(1):48-54.

  8. Graffigna M, Catoira N, Soutelo J, Azpelicueta A, Berg G, Perel C, et al. Diagn�stico de esteatosis hep�tica por m�todos cl�nicos, bioqu�micos y por imagen. Rev Argent Endocrinol Metab. 2017;54(1):37-46.

  9. Zhang S, Du T, Li M, Lu H, Lin X, Yu X. Combined effect of obesity and uric acid on nonalcoholic fatty liver disease and hypertriglyceridemia. Medicine. 2017;96(12):1-7.

  10. Sanyal AJ, Chalasani N, Kowdley K V., McCullough A, Diehl AM, Bass NM, et al. Pioglitazone, Vitamin E, or Placebo for Nonalcoholic Steatohepatitis. N Engl J Med. 2010;362(18):1675-85.

  11. Aller R, Fern�ndez-Rodr�guez C, lo Iacono O, Ba�ares R, Abad J, Carri�n JA, et al. Consensus document. Management of non-alcoholic fatty liver disease (nafld). Clinical practice guideline. Gastroenterol Hepatol. 2018;41(5):328- 49.

  12. Ryu S, Chang Y, Jung H, Yun K, Kwon M, Choi Y, et al. Relationship of sitting time and physical activity with nonalcoholic fatty liver disease. J Hepatol. 2015;63(5):1229-37.

  13. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of non‐alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55(6):2005-2023.

  14. Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, et al. Randomized Controlled Trial Testing the Effects of Weight Loss on Nonalcoholic Steatohepatitis. 2010;51(1):121-29.

  15. Sweet PH, Khoo T, Nguyen S. Nonalcoholic Fatty Liver Disease. Prim Care - Clin Off Pract. 2017;44(4):599-607.

  16. Kim D, Touros A, Kim WR. Nonalcoholic Fatty Liver Disease and Metabolic Syndrome. Clin Liver Dis. 2018;22(1):133- 40.

  17. Tsai E, Lee TP. Diagnosis and Evaluation of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis, Including Noninvasive Biomarkers and Transient Elastography. Clin Liver Dis. 2018;22(1):73-92.

  18. who. Global status report on noncommunicable diseases 2014 [Internet] [Citado 2018 abril 10]. Disponible en: http:// www.who.int/nmh/publications/ncd-status-report-2014/en/

  19. Andronescu CI, Purcarea MR, Babes PA. Nonalcoholic fatty liver disease: epidemiology, pathogenesis and therapeutic implications. J Med Life. 2018;11(1):20-3.

  20. Encuesta Nacional de Salud y Nutrici�n de Medio Camino 2016 [Internet] [Citado 2018 abril 25]. Disponible en: https://www.gob.mx/cms/uploads/attachment/file/209093/ ENSANUT.pdf

  21. Gu�a de pr�ctica cl�nica. Diagn�stico y Tratamiento de la Enfermedad Hep�tica Grasa No Alcoh�lica del Adulto [Internet] [Citado 2018 mayo 15]. Disponible en: http://www. cenetec.salud.gob.mx/descargas/gpc/CatalogoMaestro/719_ GPC_enfermedad_hepatica_grasa_no_alcoholica/719GRR. pdf

  22. Gu�a de pr�ctica cl�nica. Prevenci�n y diagn�stico de sobrepeso y obesidad en ni�os y adolescentes en el primer nivel de atenci�n [Internet] [Citado 2018 abril 18]. Disponible en: http://educads.salud.gob.mx/sitio/recursos/Sobrepeso%20 y%20Obesidad/ni%C3%B1os%20y%20adolescentes/ GPC%20UTILIZADAS/SS-025-08_GRR.pdf

  23. Targher G, Day C, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med. 2010;363(14):1341-50.

  24. Wabitsch M, Funcke J, Lennerz B, Kuhnle-Krahl U, Lahr G, Debatin K, et al. Biologically Inactive Leptin and Early- Onset Extreme Obesity. N Engl J Med. 2015;372(1):48-54.

  25. Graffigna M, Catoira N, Soutelo J, Azpelicueta A, Berg G, Perel C, et al. Diagn�stico de esteatosis hep�tica por m�todos cl�nicos, bioqu�micos y por imagen. Rev Argent Endocrinol Metab. 2017;54(1):37-46.

  26. Zhang S, Du T, Li M, Lu H, Lin X, Yu X. Combined effect of obesity and uric acid on nonalcoholic fatty liver disease and hypertriglyceridemia. Medicine. 2017;96(12):1-7.

  27. Sanyal AJ, Chalasani N, Kowdley K V., McCullough A, Diehl AM, Bass NM, et al. Pioglitazone, Vitamin E, or Placebo for Nonalcoholic Steatohepatitis. N Engl J Med. 2010;362(18):1675-85.

  28. Aller R, Fern�ndez-Rodr�guez C, lo Iacono O, Ba�ares R, Abad J, Carri�n JA, et al. Consensus document. Management of non-alcoholic fatty liver disease (nafld). Clinical practice guideline. Gastroenterol Hepatol. 2018;41(5):328- 49.

  29. Ryu S, Chang Y, Jung H, Yun K, Kwon M, Choi Y, et al. Relationship of sitting time and physical activity with nonalcoholic fatty liver disease. J Hepatol. 2015;63(5):1229-37.

  30. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of non‐alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55(6):2005-2023.

  31. Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, et al. Randomized Controlled Trial Testing the Effects of Weight Loss on Nonalcoholic Steatohepatitis. 2010;51(1):121-29.

  32. Sweet PH, Khoo T, Nguyen S. Nonalcoholic Fatty Liver Disease. Prim Care - Clin Off Pract. 2017;44(4):599-607.

  33. Kim D, Touros A, Kim WR. Nonalcoholic Fatty Liver Disease and Metabolic Syndrome. Clin Liver Dis. 2018;22(1):133- 40.

  34. Tsai E, Lee TP. Diagnosis and Evaluation of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis, Including Noninvasive Biomarkers and Transient Elastography. Clin Liver Dis. 2018;22(1):73-92.




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