Rivera-Andrade A, Kroker-Lobos M F, Lazo M, Freedman N D, Smith J W, Torres O, McGlynn K A, Groopman J D, Guallar E, Ramirez-Zea M
INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.
Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Nutr Metab Cardiovasc Dis. 2019 Feb;29(2):191-200. doi: 10.1016/j.numecd.2018.10.008. Epub 2018 Oct 31.
There are no data on the prevalence of non-alcoholic fatty liver disease (NAFLD) in general population samples in Guatemala or in other Central American countries. The prevalence and distribution of NAFLD and its associated risk factors were evaluated in a population-based sample of adults in Guatemala.
Cross-sectional study of 411 men and women 40 years of age or older residing in urban and rural areas of Guatemala. Metabolic outcomes included obesity, central obesity, hypercholesterolemia, diabetes, and metabolic syndrome (MetS). Liver disease outcomes included elevated liver enzymes, elevated Fatty Liver Index (FLI), and elevated FIB-4 score.
The overall prevalence of obesity, central obesity, diabetes, and MetS were 30.9, 74.3, 21.6, and 64.2%, respectively. The fully-adjusted prevalence ratios (95% CI) for obesity, central obesity, diabetes, and MetS comparing women to men were 2.83 (1.86-4.30), 1.72 (1.46-2.02), 1.18 (1.03-1.34), and 1.87 (1.53-2.29), respectively. The overall prevalence of elevated liver enzymes (ALT or AST), elevated FLI, and elevated FIB-4 scores were 38.4, 60.1, and 4.1%, respectively. The fully-adjusted prevalence ratios (95% CI) for elevated liver enzymes (either ALT or AST) and elevated FLI score comparing women to men were 2.99 (1.84-4.86) and 1.47 (1.18-1.84), respectively.
The prevalence of metabolic abnormalities and liver outcomes in this general population study was very high. The prevalence of metabolic and liver abnormalities was particularly high among women, an observation that could explain the atypical 1:1 male to female ratio of liver cancer in Guatemala.
在危地马拉或其他中美洲国家的普通人群样本中，尚无关于非酒精性脂肪性肝病（NAFLD）患病率的数据。在危地马拉的一个基于人群的成年样本中，对NAFLD的患病率、分布及其相关危险因素进行了评估。
对居住在危地马拉城乡地区的411名40岁及以上的男性和女性进行横断面研究。代谢指标包括肥胖、中心性肥胖、高胆固醇血症、糖尿病和代谢综合征（MetS）。肝脏疾病指标包括肝酶升高、脂肪肝指数（FLI）升高和FIB-4评分升高。
肥胖、中心性肥胖、糖尿病和MetS的总体患病率分别为30.9%、74.3%、21.6%和64.2%。女性与男性相比，肥胖、中心性肥胖、糖尿病和MetS的完全调整患病率比（95%CI）分别为2.83（1.86-4.30）、1.72（1.46-2.02）、1.18（1.03-1.34）和1.87（1.53-2.29）。肝酶升高（ALT或AST）、FLI升高和FIB-4评分升高的总体患病率分别为38.4%、60.1%和4.1%。女性与男性相比，肝酶升高（ALT或AST）和FLI评分升高的完全调整患病率比（95%CI）分别为2.99（1.84-4.86）和1.47（1.18-1.84）。
在这项普通人群研究中，代谢异常和肝脏疾病指标的患病率非常高。代谢和肝脏异常在女性中的患病率尤其高，这一观察结果可以解释危地马拉肝癌非典型的1:1男女比例。
