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

Méndez-Sánchez, Nahúm; Zamarripa-Dorsey, Felipe; Panduro, Arturo; Purón-González, Emma; Coronado-Alejandro, Edgar Ulises; Cortéz-Hernández, Carlos Alejandro; Tijera, F. Higuera de la; Pérez-Hernández, J.L.; Cerda-Reyes, Eira; Rodríguez-Hernández, Heriberto; Cruz-Ramón, Vania; Ramírez-Pérez, Oscar; Aguilar-Olivos, Nancy E.; Rodríguez-Martínez, Olga Fabiola; Cabrera-Palma, Samantha; Cabrera-Álvarez, Guillermo

doi:10.12998/wjcc.v6.i15.922

Cited by 39 publications

(25 citation statements)

References 44 publications

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Hernández-Ceballos¹,

Córdova-Gallardo²,

Méndez-Sánchez³

2021

Journal of Clinical and Translational Hepatology

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The gut microbiome plays a key role in the health-disease balance in the human body. Although its composition is unique for each person and tends to remain stable throughout lifetime, it has been shown that certain bacterial patterns may be determining factors in the onset of certain chronic metabolic diseases, such as type 2 diabetes mellitus (T2DM), obesity, metabolic-associated fatty liver disease (MAFLD), and metabolic syndrome. The gut-liver axis embodies the close relationship between the gut and the liver; disturbance of the normal gut microbiota, also known as dysbiosis, may lead to a cascade of mechanisms that modify the epithelial properties and facilitate bacterial translocation. Regulation of gut microbiota is fundamental to maintaining gut integrity, as well as the bile acids composition. In the present review, we summarize the current knowledge regarding the microbiota, bile acids composition and their association with MAFLD, obesity, T2DM and metabolic syndrome.

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Section: Introductionmentioning

confidence: 99%

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

Hernández-Ceballos¹,

Córdova-Gallardo²,

Méndez-Sánchez³

2021

Journal of Clinical and Translational Hepatology

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“…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).…”

Section: Discussionmentioning

confidence: 76%

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

Nartey

Awuku

Agyei-Nkansah

et al. 2020

Preprint

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Background: End-stage liver disease (ESLD) is a major burden on public health, particularly in sub-Saharan Africa, where hepatitis B virus (HBV) is an important risk factor. We aimed to describe clinical characteristics of ESLD from cirrhosis or hepatocellular carcinoma (HCC) and the performance of aspartate aminotransferase (AST) - platelet ratio index (APRI) and alpha fetoprotein (AFP) in Ghana. Methods: We performed an observational cross-sectional study in outpatient hepatology clinics at three teaching hospitals in Ghana, West Africa. One hundred and forty-one HCC, 216 cirrhosis and 218 chronic HBV patients were recruited by convenience sampling. Sociodemographic, history and examination, laboratory, and disease staging information were shown using descriptive statistics. Performance of the APRI score in diagnosis of cirrhosis and AFP in the diagnosis of HCC was determined using AUROC analysis.Results: Median age at presentation was 44 years for HCC and 46 years for cirrhosis. HBV was found in 69.5% of HCC and 47.2% of cirrhosis cases, and HCV in 6.4% and 3.7% respectively. APRI cut-off of 2 had sensitivity of 45.4% and specificity of 95% in diagnosis of cirrhosis, and cut-off of 1 had sensitivity of 75.9% and specificity of 89%. AUC of AFP was 0.88 (95% CI 0.81-0.94) in diagnosis of HCC. Low monthly income was associated with lower odds of undertaking AFP. Thirty one percent of cirrhotic persons were Child-Pugh C, and 67.9% of HCC patients had advanced or terminal disease at presentation. Conclusions: Our findings emphasize the young age of ESLD patients in Ghana and the advanced nature at presentation. It highlights shortcomings in surveillance and the need for policies to address the burden and improve outcomes in Ghana.

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“…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] .…”

Section: Alcoholic Liver Disease and Hccmentioning

confidence: 99%

“…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.…”

Section: Microbiota and Its Interaction With The Intestinal Environmentmentioning

confidence: 99%

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

Méndez-Sánchez

Valencia-Rodríguez

Vera-Barajas

et al. 2020

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Currently, alcoholic liver disease (ALD) is one of the most prevalent chronic liver diseases worldwide, representing one of the main etiologies of cirrhosis and hepatocellular carcinoma (HCC). Although we do not know the exact mechanisms by which only a selected group of patients with ALD progress to the final stage of HCC, the role of the gut microbiota within the progression to HCC has been intensively studied in recent years. To date, we know that alcohol-induced gut dysbiosis is an important feature of ALD with important repercussions on the severity of this disease. In essence, an increased metabolism of ethanol in the gut induced by an excessive alcohol consumption promotes gut dysfunction and bacterial overgrowth, setting a leaky gut. This causes the translocation of bacteria, endotoxins, and ethanol metabolites across the enterohepatic circulation reaching the liver, where the recognition of the pathogen-associated molecular patterns via specific Toll-like receptors of liver cells will induce the activation of the nuclear factor kappa-B pathway, which releases pro-inflammatory cytokines and chemokines. In addition, the mitogenic activity of hepatocytes will be promoted and cellular apoptosis will be inhibited, resulting in the development of HCC. In this context, it is not surprising that microbiota-regulating drugs have proven effectiveness in prolonging the overall survival of patients with HCC, making attractive the implementation of these drugs as co-adjuvant for HCC treatment.

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

Cited by 39 publications

References 44 publications

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

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

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

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

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