Prevalence of metabolic syndrome, obesity and diabetes type 2 in cryptogenic cirrhosis

Téllez-Ávila, Félix Ignacio; Ávila, Juan Francisco Sánchez; Garcia‐Saenz‐de‐Sicilia, Mauricio; Chavez-Tapia, Norberto C; Franco-Guzmán, Ada M.; López-Arce, Gustavo; Cerda-Contreras, Eduardo; Uribe, Misael

doi:10.3748/wjg.14.4771

Cited by 61 publications

(54 citation statements)

References 21 publications

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“…In this series, the prevalence of obesity in CC group was 27.5%, higher than that reported by Tellez-Avila et al (31) (16.4%), but lower than that reported by other authors (7,23) (approximately 47%). In group 3, this prevalence was around 20%, with no statistically significant difference compared with the CC group.…”

Section: Discussioncontrasting

confidence: 51%

“…Note that this percentage of patients with high glycemia was higher than that described in the literature (7,23,26,31) , where this value is around 40%-53%. Nevertheless, it is important to remind that these studies considered only the prevalence of diabetes and did not evaluate patients with impaired fasting glucose.…”

Section: Discussioncontrasting

confidence: 44%

“…Some authors (7,22,26,31) have observed a higher prevalence of females, while others (9,30) have observed a higher prevalence of males. In the present study, patients with CC were divided almost equally between genders.…”

Section: Discussionmentioning

confidence: 99%

“…A portion of these cases is attributed to non-alcoholic steatohepatitis (NASH), since, when cirrhosis is established, patients no longer present typical histological characteristics of NASH, thus, preventing its clinical recognition (1,8,24) . A causal relationship between both entities could be suggested by the study of risk factors for NASH in patients with CC and/or by following NASH cases with serial liver biopsies (4,7,9,16,17,22,23,26,27,30,31) . Most NASH cases are associated with insulin resistance (IR), so that nonalcoholic fatty liver disease (NAFLD) has been considered the hepatic component of metabolic syndrome (MS) (11,20) .…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for nonalcoholic steatohepatitis in cryptogenic cirrhosis

Leite

Mattos

Coral

et al. 2012

Arq. Gastroenterol.

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-Context -In about 10% of patients with chronic liver disease, it is not possible to identify an etiologic factor. These cases are called cryptogenic cirrhosis. Currently, nonalcoholic steatohepatitis (NASH) is being considered as a possible etiologic factor for a significant segment of patients that presents with cryptogenic cirrhosis. Objective -To estimate the prevalence of risk factors for NASH in patients with cryptogenic cirrhosis, in order to verify if there is a causal relationship between them. Method -Cross-sectional study, with evaluation of the demographic and laboratorial data of patients with cryptogenic cirrhosis. They were compared with data obtained from a group with NASH and a group with alcoholic and/or hepatitis C (HCV) cirrhosis. Results -Forty seven patients with cryptogenic cirrhosis were evaluated, 47 with NASH and 196 with HCV and/or alcoholic cirrhosis. The mean age of patients with cryptogenic cirrhosis was 52 years, while in those with NASH it was 46.4 years (P = 0,041). The group with cryptogenic cirrhosis had 23 female and 24 male patients. Of the patients who presented with NASH, 68.1% were female. Of the patients who presented with alcoholic/HCV cirrhosis, 64.8% were male. There were no statistically significant differences between the groups. In cryptogenic cirrhosis patients, the following prevalences could be observed: impaired fasting glycemia -68.2%; obesity -27.5%; total hypercholesterolemia -27.9%; low HDL levels -58.1% (women -81%; men -36.4%); hypertriglyceridemia -16.3%. The results seen in cryptogenic cirrhosis patients showed statistical similarity with the results of the NASH group regarding fasting glycemia (62.8%) and male HDL levels (53.8%). The comparison with the alcoholic/HCV cirrhosis group showed statistical differences regarding fasting glycemia (45.2%), hypercholesterolemia (13.3%) and female HDL levels (50.8%). Conclusions -It is not possible to establish a causal relationship between cryptogenic cirrhosis and NASH. Only data related to fasting glycemia and HDL levels in male patients showed statistical similarities between both groups of patients. HEADINGS -Liver cirrhosis. Fatty liver. Metabolic diseases.Declared conflict of interest of all authors: none.

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Section: Discussioncontrasting

confidence: 51%

Section: Discussioncontrasting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for nonalcoholic steatohepatitis in cryptogenic cirrhosis

Leite

Mattos

Coral

et al. 2012

Arq. Gastroenterol.

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“…63 Metabolic syndrome (MS) is very common after liver transplantation (43%-58% in various series as compared to a pretransplant prevalence of 5-29%). 64 It has been associated with increased risks of cardiovascular disease, cardiovascular death, liver-related death, and overall mortality. [65][66][67] Among the various causative factors for development of post liver transplant metabolic syndrome, effects of immunosuppression (calcineurin inhibitors, mTOR inhibitors and steroids) are the most important.…”

Section: Kidney Injury and Immunosuppressionmentioning

confidence: 99%

Current Status of Immunosuppression in Liver Transplantation

Choudhary

Saigal

Shukla

et al. 2013

Journal of Clinical and Experimental Hepatology

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With advancements in immunosuppressive strategies and availability of better immunosuppressive agents, survival rate following liver transplantation has improved significantly in the recent times. Besides improvements in surgical techniques, the most important factor that has contributed to this better outcome is the progress made in the field of immunosuppression. Over the last several years, the trend has changed to tailored immunosuppression with the aim of achieving optimal graft function while avoiding its undesirable side effects. Induction agents are no longer used routinely and the aim is to provide minimal immunosuppression in the maintenance phase. The present review discusses the various types of immunosuppressive agents, their mechanism of action, clinical utility, advantages and disadvantages, and their side effects in short and long-term. It also discusses about tailoring immunosuppression in presence of various situations such as renal dysfunction, metabolic syndrome, hepatitis C recurrence, cytomegalovirus infections and so on. The issue of chronic kidney disease and the available renal sparing immunosuppressive strategies has been particularly stressed upon. Finally, it discusses about the practical aspects of various immunosuppression regimens including drug monitoring. ( J CLIN EXP HEPATOL 2013;3:150-158)

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