Norberto Chávez-Tapia, Jorge Torres-Sánchez, Juan Romero-Flores, Paulina Álvarez-Quiroz, Sandra Ramírez-Álvarez, Eva Juárez-Hernández, José Pérez-Jáuregui, Nahum Méndez-Sánchez, Misael Uribe
Background. Transient elastography (TE) is a useful tool for the assessment of hepatic fibrosis as an alternative to liver biopsy, but it has not been validated as a screening procedure in apparently healthy people. Aim. To determine the prevalence of advanced liver fibrosis diagnosed by TE in a socioeconomically challenged rural population. Material and methods. We enrolled 299 participants aged over 18 years old from a vulnerable population in Mexico who responded to an open invitation. All participants had their history recorded and underwent a general clinical examination and a liver stiffness measurement, performed by a single operator according to international standards. Results. Overall, 7.35% participants were found to be at high risk for cirrhosis. Three variables correlated with a risk for a TE measure ? 9 kPa and significant fibrosis: history of alcohol intake [7.95 vs. 92.04%, odds ratio (OR) 4.47, 95% confidence interval (CI) 1.45-13.78, P = 0.0167], body mass index (BMI) ? 30 kg/m2 (30.87 vs. 69.12%, OR 4.25, 95%CI 1.04-6.10, P = 0.049), and history of diabetes mellitus (14.87 vs. 85.12%, OR 2.76, 95%CI 1.002-7.63, P = 0.0419). In the multivariate analyses BMI ? 30 kg/m2 was the only significant risk factor for advanced liver fibrosis or cirrhosis (OR 2.54, 95%CI 1.02-6.3, P = 0.0460). Conclusion. TE could be useful as a screening process to identify advanced liver fibrosis in the general and apparently healthy population.
Key words. Liver cirrhosis., Body mass index., Developing country., Risk factors., Morbidity.