Nahum Méndez-Sánchez, Claudia P. Sánchez-Castillo, Antonio R Villa, Herlinda Madrigal, Beatriz Merino, Elsy García, Patricia López, Edgar Pichardo-Ontiveros, Misael Uribe
Background & Aim: Liver cirrhosis continues to be an important cause of death in Mexico. Some data suggest that being overweight is a risk factor for chronic liver disease. The aim of this study was to assess the link between the incidences of being overweight or obese and mortality from liver cirrhosis in Mexico during the period 1990-2001. Methods: We designed and conducted an ecological study of trends with multiple comparisons of regions of Mexico (North, Central, Mexico City, and South). We built the time trends according to the mortality rates of liver cirrhosis reported by the System of Vital Statistics (Health Ministry) in each state for each year from 1990 to 2001. The information on prevalences of overweight (body mass index (BMI) = 25-29.9) and obesity (BMI • 30) was from two national surveys (1993 and 2000). Results: The analysis of mortality trends in liver cirrhosis by region showed an increase in the risk of death across time. This risk was considerably higher for the South Region (β = 1.03, p <0.0001). The mortality rates remained higher than 30 per 100,000 inhabitants. When we selected the three states with the highest mortality rates for each region, the most significant changes in the trends were in the North and South regions (β = 0.75, p <0.0001 and β = 1.29, p <0.0001, respectively). In addition, the prevalence of overweight in the four regions increased from 1993 to 2000 (percentage change, 10.2-48.2). Obesity was most prevalent in the North and South regions in 1993. Conclusion: Our observations support the hypothesis that obesity might play an important role in the risk of developing liver cirrhosis.
Key words. Obesity, liver cirrhosis, non alcoholic steatohepatitis, mortality, cryptogenic, Mexico