Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2018; 6(15): 922-930
Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.922
Current trends of liver cirrhosis in Mexico: Similitudes and differences with other world regions
Nahum Méndez-Sánchez, Felipe Zamarripa-Dorsey, Arturo Panduro, Emma Purón-González, Edgar Ulises Coronado-Alejandro, Carlos Alejandro Cortez-Hernández, Fátima Higuera de la Tijera, José Luis Pérez-Hernández, Eira Cerda-Reyes, Heriberto Rodríguez-Hernández, Vania César Cruz-Ramón, Oscar Lenin Ramírez-Pérez, Nancy Edith Aguilar-Olivos, Olga Fabiola Rodríguez-Martínez, Samantha Cabrera-Palma, Guillermo Cabrera-Álvarez
Nahum Méndez-Sánchez, Vania César Cruz-Ramón, Oscar Lenin Ramírez-Pérez, Nancy Edith Aguilar-Olivos, Olga Fabiola Rodríguez-Martínez, Liver Research Unit, Medica Sur Clinic and Foundation, Mexico City 14050, Mexico
Felipe Zamarripa-Dorsey, Department of Gastroenterology, Hospital “Juárez” of México, Mexico City 07760, Mexico
Arturo Panduro, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara “Fray Antonio Alcalde”, Guadalajara 44280, Jalisco, Mexico
Emma Purón-González, Edgar Ulises Coronado-Alejandro, Department of Internal Medicine, “Christus Muguerza “Super Specialty” Hospital” Monterrey, Monterrey 64060, Nuevo León, Mexico
Carlos Alejandro Cortez-Hernández, Department of Gastroenterology, “University Hospital “Jose Eleuterio González” Monterrey, Monterrey 64060, Nuevo León, Mexico
Fátima Higuera de la Tijera, José Luis Pérez-Hernández, Department of Gastroenterology, “General Hospital of Mexico “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico
Eira Cerda-Reyes, Department of Gastroenterology, “Central Military Hospital”, Mexico City 11200, Mexico
Heriberto Rodríguez-Hernández, Faculty of Medicine and Nutrition, Juárez University of the State of Durango, Durango 34100, Mexico
Samantha Cabrera-Palma, Guillermo Cabrera-Álvarez, Liver Clinic, Regional General Hospital IMSS 1, Cuernavaca 62450, Morelos, Mexico
Author contributions: Méndez-Sánchez N conceptualized the study; Zamarripa-Dorsey FZ and Panduro A contributed to the methodology; Aguilar-Olivos NE and Rodríguez-Martínez OF; Validation, Higuera de la Tijera F, Pérez-Hernández JL, Rodríguez-Hernández HR, Cortez–Hernández CA, Cerda-Reyes E and Cabrera-Álvarez G contributed to the software; Purón-González E, Coronado-Alejandro EU, Cabrera-Palma S contributed to the investigation; Cruz-Ramón VC and Ramírez-Pérez OL contributed to the writing-original draft preparation; Méndez-Sánchez N contributed to the writing-review and editing; Méndez-Sánchez N, Zamarripa-Dorsey F, Panduro A, Cortez-Hernández CA, Cerda-Reyes E, Higuera de la Tijera F, Pérez-Hernández JL, Rodríguez-Hernández H and Cabrera-Palma S contributed to the supervision of the study.
Supported by Medica Sur Clinic and Foundation (in part).
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Medica Sur Clinic and Foundation.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nahum Méndez-Sánchez, MD, MSc, PhD, FACG, AGAF, FAASLD, Academic Research, Professor, Liver Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, Mexico City14050, Mexico. nmendez@medicasur.org.mx
Telephone: +525-55-4247200-4215 Fax: +525-55-6664031
Received: September 6, 2018
Peer-review started: September 6, 2018
First decision: October 11, 2018
Revised: October 19, 2018
Accepted: November 14, 2018
Article in press: November 15, 2018
Published online: December 6, 2018
Abstract
AIM

To investigate the main current etiologies of cirrhosis in Mexico.

METHODS

We 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).

RESULTS

A 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%).

CONCLUSION

HCV 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.

Keywords: Alcoholic liver disease, Hepatitis C virus, Nonalcoholic steatohepatitis, Liver cirrhosis

Core tip: In 2004, a Mexican study reported the most common causes of liver cirrhosis were alcoholic liver disease (39.5%), hepatitis C virus (36.6%), and non-alcoholic fatty liver disease (10.4%). We believe that the epidemiology of cirrhosis has changed because of the increasing prevalence of obesity, metabolic syndrome, and autoimmune diseases. Therefore, we performed a cross-sectional multicenter study that included eight hospitals of different areas of Mexico in order to know the current epidemiology of liver cirrhosis in this country.