Castro-Martínez María Guadalupe, Banderas-Lares Diana Zaineff, Ramírez-Martínez Jesús Cenobio, Escobedo-de la Peña Jorge
Servicio de Medicina Interna. Hospital General Regional No. 1. Instituto Mexicano del Seguro Social, Mexico, D.F., Mexico.
Cir Cir. 2012 Mar-Apr;80(2):128-33.
Nonalcoholic fatty liver disease (NAFLD) is the main cause of chronic liver disease. Metabolic syndrome (MetS) is an important predictor of NAFLD. Due to the increase of MetS in Mexico, a population-based cross-sectional study was conducted to estimate the prevalence of NAFLD.
One hundred ninety eight subjects with MetS were randomly selected from 1006 subjects and were invited to participate in the estimation of the prevalence of NAFLD. MetS was diagnosed following the criteria of the National Cholesterol Education Program (ATPIII-NCEP). Abdominal ultrasound was performed and left, right and caudate lobes were assessed according to size, echogenicity and hepatic borders. NAFLD was classified as mild, moderate and severe according to its echogenicity and visualization of the diaphragm and intrahepatic vessel borders. Prevalence of NAFLD was estimated with 95% confidence intervals (95% CI).
Included in the study were 122 males (63.2%) and 71 females (36.8%). Prevalence of NAFLD was 82.9% (95% CI 77.6-88.2%). Prevalence was higher in males (p = 86.9%; 95% CI 80.9-92.9%) than in females (p = 76.1%; 95% CI 66.1-86.0%). There were no age differences. A higher proportion of patients had mild (52.3%) or moderate (22.3%) NAFLD and in only 16 patients was NAFLD severe (8.3%).
The observed prevalence is alarming because 8/10 subjects with MetS had NAFLD in any stage. Health-related measures oriented to decrease the incidence of the MetS will have a favorable impact on the occurrence of NAFLD.
非酒精性脂肪性肝病（NAFLD）是慢性肝病的主要病因。代谢综合征（MetS）是NAFLD的重要预测指标。由于墨西哥MetS患者数量增加，开展了一项基于人群的横断面研究以估算NAFLD的患病率。
从1006名受试者中随机选取198名患有MetS的受试者，并邀请他们参与NAFLD患病率的估算。根据美国国家胆固醇教育计划（ATPIII-NCEP）的标准诊断MetS。进行腹部超声检查，并根据大小、回声性和肝脏边界评估左叶、右叶和尾状叶。根据NAFLD的回声性以及膈肌和肝内血管边界的可视化情况将其分为轻度、中度和重度。采用95%置信区间（95%CI）估算NAFLD的患病率。
纳入研究的有122名男性（63.2%）和71名女性（36.8%）。NAFLD的患病率为82.9%（95%CI 77.6 - 88.2%）。男性患病率（p = 86.9%；95%CI 80.9 - 92.9%）高于女性（p = 76.1%；95%CI 66.1 - 86.0%）。不存在年龄差异。较高比例的患者患有轻度（52.3%）或中度（22.3%）NAFLD，只有16名患者为重度NAFLD（8.3%）。
观察到的患病率令人担忧，因为每10名患有MetS的受试者中有8名处于NAFLD的任何阶段。旨在降低MetS发病率的健康相关措施将对NAFLD的发生产生有利影响。
