A Rivera-Andrade1, M F Kroker-Lobos1, M Lazo2, N D Freedman3, J W Smith4, O Torres5, K A McGlynn3, J D Groopman4, E Guallar6, M Ramirez-Zea1. 1. INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala. 2. 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. 3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 20892, USA. 4. Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. 5. Laboratorio de Diagnóstico Molecular, Guatemala City, Guatemala. 6. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. Electronic address: eguallar@jhu.edu.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Ahlia Sekkarie; Siran He; Jean A Welsh; Usha Ramakrishnan; Aryeh D Stein; Miriam B Vos Journal: Ann Hepatol Date: 2020-05-16 Impact factor: 2.400
Authors: John D Groopman; Joshua W Smith; Alvaro Rivera-Andrade; Christian S Alvarez; María F Kroker-Lobos; Patricia A Egner; Eduardo Gharzouzi; Michael Dean; Katherine A McGlynn; Manuel Ramírez-Zea Journal: World Mycotoxin J Date: 2021-04-07 Impact factor: 3.353
Authors: Mariana Lazo; Jiaqi Xie; Christian S Alvarez; Dominick Parisi; Stephanie Yang; Alvaro Rivera-Andrade; Maria F Kroker-Lobos; John D Groopman; Eliseo Guallar; Manuel Ramirez-Zea; Dan E Arking; Katherine A McGlynn Journal: Liver Int Date: 2022-04-12 Impact factor: 8.754
Authors: Alvaro Rivera-Andrade; Jessica L Petrick; Christian S Alvarez; Barry I Graubard; Andrea A Florio; Maria F Kroker-Lobos; Dominick Parisi; Neal D Freedman; Mariana Lazo; Eliseo Guallar; John D Groopman; Manuel Ramirez-Zea; Katherine A McGlynn Journal: Aliment Pharmacol Ther Date: 2022-04-28 Impact factor: 9.524
Authors: Christian S Alvarez; Jeremy Ortiz; Giovanna Bendfeldt-Avila; Yi Xie; Mingyi Wang; Dongjing Wu; Herbert Higson; Elisa Lee; Kedest Teshome; Joaquin Barnoya; David E Kleiner; John D Groopman; Roberto Orozco; Katherine A McGlynn; Eduardo Gharzouzi; Michael Dean Journal: Health Sci Rep Date: 2020-05-06
Authors: Christian S Alvarez; Alvaro Rivera-Andrade; María F Kroker-Lobos; Andrea A Florio; Joshua W Smith; Patricia A Egner; Neal D Freedman; Mariana Lazo; Eliseo Guallar; Michael Dean; Barry I Graubard; Manuel Ramírez-Zea; Katherine A McGlynn; John D Groopman Journal: Health Sci Rep Date: 2022-01-20
Authors: Christian S Alvarez; Andrea A Florio; Julia Butt; Alvaro Rivera-Andrade; María F Kroker-Lobos; Tim Waterboer; Maria Constanza Camargo; Neal D Freedman; Barry I Graubard; Mariana Lazo; Eliseo Guallar; John D Groopman; Manuel Ramírez-Zea; Katherine A McGlynn Journal: Helicobacter Date: 2020-10-02 Impact factor: 5.182
Authors: Joshua W Smith; Derek K Ng; Christian S Alvarez; Patricia A Egner; Sean M Burke; Jian-Guo Chen; Thomas W Kensler; Jill Koshiol; Alvaro Rivera-Andrade; María F Kroker-Lobos; Manuel Ramírez-Zea; Katherine A McGlynn; John D Groopman Journal: Toxins (Basel) Date: 2022-02-23 Impact factor: 4.546