Current trends of liver cirrhosis in Mexico: Similitudes and differences with other world regions

Abstract

AIMTo investigate the main current etiologies of cirrhosis in Mexico.METHODSWe performed a cross-sectional retrospective multicenter study that included eight hospitals in different areas of Mexico. These hospitals provide health care to people of diverse social classes. The inclusion criteria were a histological, clinical, biochemical, endoscopic, or imaging diagnosis of liver cirrhosis. Data were obtained during a 5-year period (January 2012-December 2017).RESULTSA total of 1210 patients were included. The mean age was 62.5 years (SD = 12.1), and the percentages of men and women were similar (52.0% vs 48.0%). The most frequent causes of liver cirrhosis were hepatitis C virus (HCV) (36.2%), alcoholic liver disease (ALD) (31.2%), and nonalcoholic steatohepatitis (23.2%), and the least frequent were hepatitis B virus (1.1%), autoimmune disorders (7.3%), and other conditions (1.0%).CONCLUSIONHCV and ALD are the most frequent causes of cirrhosis in Mexico. However, we note that non-alcoholic fatty liver disease (NAFLD) as an etiology of cirrhosis increased by 100% compared with the rate noted previously. We conclude that NAFLD will soon become one of the most frequent etiologies of liver cirrhosis in Mexico.

Gut Microbiota in Metabolic-associated Fatty Liver Disease and in Other Chronic Metabolic Diseases

“…1 Metabolic-associated fatty liver disease (MAFLD) affects 25% of the global population, [2][3][4][5][6][7][8][9] representing the principal cause of chronic liver disease. [10][11][12] This phenomenon can be associated with the modern lifestyle across industrialized countries that favors a sedentary life and high-calorie diets, thus promoting obesity and other chronic comorbidities. This situation constitutes a serious public health problem.…”

Ambulatory end-stage liver disease in Ghana; patient profile and utility of alpha fetoprotein and aspartate aminotransferase - platelet ratio index.

“…Although the economic impact of the burden of disease has not been fully enumerated in Ghana, there is evidence from countries in which preventive and treatment strategies do exist, that there is a high economic burden and signi cant loss of productivity associated with the diagnosis of liver cirrhosis (16). Other studies in Asia and the Americas demonstrate a mean age at diagnosis of cirrhosis of about 60 years, over a decade older than observed in Ghana (17,18).…”

The mechanism of dysbiosis in alcoholic liver disease leading to liver cancer

“…On its own, ALD is one of the less frequent etiologies that progress to HCC [6,7] ; however, its high prevalence continues to position it as one of the most important chronic liver diseases (CLDs) for public health [8] . Recently, our group of work conducted a study to determine the main etiologies of cirrhosis worldwide [ Figure 1] finding interesting results among countries [9] .…”

“…The colonization of the healthy gut environment contributes to the development of the intestinal architecture and the proper functioning of the immune system. Colon bacteria can ferment nutrients and Sánchez et al [9] . HCV: hepatitis C virus; ALD: alcoholic liver disease; NASH: non-alcoholic steatohepatitis; HBV: hepatitis B virus; NAFLD: non-alcoholic fatty liver disease endogenous substrates derived from the host, such as mucus and pancreatic enzymes, as well as dietary components that are not absorbed in the first portions of the GI tract.…”