Identificación de características sociodemográficas, medidas antropométricas y comorbilidades en personas con enfermedad hepática esteatósica asociada a disfunción metabólica atendidos en el servicio de consulta externa en Mi Red IPS entre enero de 2021 y diciembre de 2022
| dc.contributor.advisor | Bornacelly Mendoza, Adriana | |
| dc.contributor.advisor | Mendoza Torres, Evelin | |
| dc.contributor.author | Barcinilla Barros, Jairo Enrique | |
| dc.contributor.author | De Ávila Consuegra, Iván Alfredo | |
| dc.coverage.spatial | Barranquilla | spa |
| dc.creator.email | jairoe-barcinillab@unilibre.edu.co | spa |
| dc.creator.email | ivan-deavilac@unilibre.edu.co; | spa |
| dc.date.accessioned | 2024-07-16T20:02:08Z | |
| dc.date.available | 2024-07-16T20:02:08Z | |
| dc.date.created | 2024-06 | |
| dc.description.abstract | Introducción: MASLD engloba a pacientes con esteatosis hepática definida por acumulación anormal de lípidos en más del 5% de los hepatocitos y al menos uno de cinco factores de riesgo cardiometabólico (IMC o circunferencia abdominal (hombres >= 94 cm, mujeres >= 80 cm ), hipertensión arterial, diabetes mellitus tipo 2, hiperlipidemia e hipertrigliceridemia), La MASLD es una de las causas más importantes de enfermedad hepática en todo el mundo y probablemente emergerá como la principal causa de enfermedad hepática terminal en las próximas décadas, el objetivo del estudio fue Identificar variables sociodemográficas, medidas antropométricas y comorbilidades en personas con enfermedad hepática esteatósica asociada a disfunción metabólica (MASLD) atendidas en el servicio de consulta externa en Mi Red Barranquilla entre enero del 2021 y diciembre del 2022. Metodología: estudio observacional, descriptivo, transversal, en el que se determinaron las características sociodemográficas y comorbilidades más frecuentes en personas con diagnóstico de enfermedad hepática esteatósica asociada a disfunción metabólica (MASLD) atendidos en el servicio de consulta externa en Mi Red IPS entre Enero de 2021 y Diciembre de 2022. Este estudio también tiene un componente analítico debido a que se determinaron asociaciones entre variables independientes, con el grado de esteatosis. Resultados: se estudiaron 252 que tenían hallazgo de algún grado de esteatosis hepática de los cuales 197 pacientes, (78.2%) eran del género femenino, la edad promedio 58,2 años, el 56.7% de los pacientes tenían sobrepeso/obesidad con media de IMC 32,7, el 81% tenían obesidad central, el 57% tenían hipertensión arterial , y el 100% diabetes mellitus tipo 2 Conclusiones: en el presente estudio se evidencio predominio por el género femenino, a mayor edad en pacientes con MASLD, existe una mayor severidad de esteatosis hepática. A mayor grado de obesidad en pacientes con MASLD, mayor será́ la severidad de esteatosis hepática. Nuestros hallazgos son congruentes con los reportes en la literatura. | spa |
| dc.description.abstractenglish | Introduction: MASLD encompasses patients with hepatic steatosis defined by abnormal lipid accumulation in more than 5% of hepatocytes and at least one of five cardiometabolic risk factors (BMI or abdominal circumference (men >= 94 cm, women >= 80 cm ), arterial hypertension, type 2 diabetes mellitus, hyperlipidemia and hypertriglyceridemia), MASLD is one of the most important causes of liver disease worldwide and will probably emerge as the main cause of end-stage liver disease in the coming decades, the goal of The study was to identify sociodemographic variables, anthropometric measurements and comorbidities in people with steatotic liver disease associated with metabolic dysfunction (MASLD) treated in the outpatient service at MiRed Barranquilla between January 2021 and December 2022. Methodology: observational, descriptive study, cross-sectional, in which the most frequent sociodemographic characteristics and comorbidities were determined in people with a diagnosis of steatotic liver disease associated with metabolic dysfunction (MASLD) treated in the outpatient service at MiRed IPS between January 2021 and December 2022. This The study also has an analytical component because associations were determined between independent variables and the degree of steatosis. Results: 252 were studied who had a finding of some degree of hepatic steatosis, of which 197 patients (78.2%) were female, the average age was 58.2 years, 56.7% of the patients had overweight/obesity with a mean of BMI 32.7, 81% had central obesity, 57% had high blood pressure, and 100% had type 2 diabetes mellitus. Conclusions: in the present study, there was evidence of a predominance of the female gender, at older age in patients with MASLD, there is a greater severity of hepatic steatosis. The greater the degree of obesity in patients with MASLD, the greater the severity of hepatic steatosis. Our findings are consistent with reports in the literature. | spa |
| dc.description.sponsorship | Universidad Libre Seccional Barranquilla -- Facultad de Ciencias de la Salud -- Especialización en Medicina Interna | spa |
| dc.format | spa | |
| dc.identifier.uri | https://hdl.handle.net/10901/29446 | |
| dc.relation.references | 1. Targher, G., Byrne, C. D., & Tilg, H. MASLD: a systemic metabolic disorder with cardiovascular and malignant complications. Gut, 73(4), gutjnl-2023-330595. https://doi.org/10.1136/gutjnl-2023-330595 | spa |
| dc.relation.references | 2. Younossi ZM, Golabi P, Price JK, Owrangi S, Gundu-Rao N, Satchi R, et al. The global epidemiology of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among patients with type 2 diabetes. Clin Gastroenterol Hepatol 2024. https://doi.org/10.1016/j.cgh.2024.03.006 | spa |
| dc.relation.references | 3. Powell EE, Wong VW, Rinella M. Non-alcoholic fatty liver disease. Lancet. 2021;397(10290):2212-2224 | spa |
| dc.relation.references | 4. Lekakis, V., & Papatheodoridis, G. V. Natural history of metabolic dysfunction-associated steatotic liver disease. European Journal of Internal Medicine, 2024;122, 3–10 | spa |
| dc.relation.references | 5. Rao G, Peng X, Li X, An K, He H, Fu X, et al. Unmasking the enigma of lipid metabolism in metabolic dysfunction-associated steatotic liver disease: from mechanism to the clinic. Front Med (Lausanne) [Internet]. 2023 [citado el 12 de mayo de 2024];10. Disponible en: http://dx.doi.org/10.3389/fmed.2023.1294267 | spa |
| dc.relation.references | 6. Sheka AC, Adeyi O, Thompson J, Hameed B, Crawford PA, Ikramuddin S. Nonalcoholic Steatohepatitis: A Review [published correction appears in JAMA. 2020 | spa |
| dc.relation.references | 7. Vanegas R, Claudia Marcela et al.Caracterización de pacientes con enfermedad del hígado graso no alcohólica en un hospital de alta complejidad, Colombia 2013.Rev Col Gastroenterol [online]. 2014, vol.29, n.4, pp.342-346. ISSN 0120-9957 | spa |
| dc.relation.references | 8. Lambis L, Belisario Solana J, Gastelbondo B, Romero D, Garrido D, Puello W, García M, Suárez A. Factores de riesgo asociados a hígado graso de origen no alcohólico en una población del Caribe Colombiano. Rev. colomb. Gastroenterol. [Internet]. 30 de junio de 2016 [citado 4 de mayo de 2023];31(2):89-95 | spa |
| dc.relation.references | 9. Cotter TG, Rinella M. Nonalcoholic fatty liver disease 2020: The state of the disease. Gastroenterology 2020;158:1851–64 | spa |
| dc.relation.references | 10. Araújo AR, Rosso N, Bedogni G, Tiribelli C, Bellentani S. Global epidemiology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: What we need in the future. Liver Int. 2018;38 Suppl 1:47-51 | spa |
| dc.relation.references | 11. Falck-Ytter Y, Younossi ZM, Marchesini G, McCullough AJ. Clinical features and natural history of nonalcoholic steatosis syndromes. Semin Liver Dis 2001; 21:17 | spa |
| dc.relation.references | 12. Miao, L., Targher, G., Byrne, C. D., Cao, Y.-Y., & Zheng, M.-H. Current status and future trends of the global burden of MASLD. Trends in Endocrinology and Metabolism: TEM. 2024 | spa |
| dc.relation.references | 13. Zhao Q, Deng Y. Comparison of mortality outcomes in individuals with MASLD and/or MAFLD. J Hepatol. 2023 Aug 11:S0168-8278(23)05055-9 | spa |
| dc.relation.references | 14. Pardo SS, Díaz LR, Pacheco SH, Prieto Ortiz JE. Características clínicas de los pacientes con diagnóstico de hígado graso de la Clínica Universitaria Colombia, periodo 2010-2013. Rev Médica Sanitas 2013;16:170–9 | spa |
| dc.relation.references | 15. Thaler H. The fatty liver and its pathogenetic relation to liver cirrhosis. Virchows Arch Pathol Anat Physiol Klin Med 1962;335:180–210 | spa |
| dc.relation.references | 16. Ludwig J, Viggiano TR, McGill DB, et al. Non alcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc 1980;55:434–438 | spa |
| dc.relation.references | 17. Seto WK, Yuen MF. Non-alcoholic fatty liver disease in Asia: emerging perspectives. J Gastroenterol 2017;52:164 | spa |
| dc.relation.references | 18. Cruz ACD, at el. Characteristics and long-term prognosis of lean patients with nonalcoholic fatty liver disease. Gastroenterology 2014;146(5):909 | spa |
| dc.relation.references | 19. Niriella MA, Kasturiratne A, Pathmeswaran A, De Silva ST, Perera KR, Subasinghe SKCE, et al. Lean non-alcoholic fatty liver disease (lean NAFLD): characteristics, metabolic outcomes and risk factors from a 7-year prospective, community cohort study from Sri Lanka. Hepatol Int 2019;13:314–22 | spa |
| dc.relation.references | 20. Kwon OY, Kim SU, Ahn SH, Jang Y. Self-Management and Associated Factors among Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study. Int J Environ Res Public Health. 2022;20(1):667 | spa |
| dc.relation.references | 21. Hall, J. E., Guyton, A. C., & Hall, M. E. (2021). Tratado de fisiología médica.14a | spa |
| dc.relation.references | 22. Boyer JL. Bile formation and secretion [Internet]. Comprehensive Physiology. Wiley; 2013. p. 1035–78. Disponible en: http://dx.doi.org/10.1002/cphy.c120027 | spa |
| dc.relation.references | 23. Dixon LJ, Barnes M, Tang H, et al: Kupffer cells in the liver. Compr Physiol 3:785, 2013 | spa |
| dc.relation.references | 24. Sorensen KK, Simon-Santamaria J, McCuskey RS, Smedsrød B: Liver sinusoidal endothelial cells. Compr Physiol 5:1751, 2015 | spa |
| dc.relation.references | 25. Manterola C, del-Sol M, Ottone N, Otzen T. Anatomía Quirúrgica y Radiológica del Hígado. Fundamentos para las Resecciones Hepáticas. Int J Morphol 2017;35:1525–39 | spa |
| dc.relation.references | 26. Kalra A, Yetiskul E, Wehrle CJ, Tuma F. Physiology, Liver. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 8, 2022 | spa |
| dc.relation.references | 27. Feldman M, Friedman LS, Brandt LJ, editors. Sleisenger Y Fordtran. Enfermedades Digestivas Y Hepaticas: Fisiopatología, Diagnóstico Y Tratamiento. 11th ed. Elsevier; 2021 | spa |
| dc.relation.references | 28. Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero-Gomez M, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol [Internet]. 2020;73(1):202–9 | spa |
| dc.relation.references | 29. Rinella ME, Lazarus JV, Ratziu V, Francque SM, Sanyal AJ, Kanwal F, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol [Internet]. 2023;79(6):1542–56. Disponible en: http://dx.doi.org/10.1016/j.jhep.2023.06.003 | spa |
| dc.relation.references | 30. Hardy T, Wonders K, Younes R, Aithal GP, Aller R, Allison M, et al. The European NAFLD Registry: A real-world longitudinal cohort study of nonalcoholic fatty liver disease. Contemp Clin Trials [Internet]. 2020;98(106175):106175. Disponible en: http://dx.doi.org/10.1016/j.cct.2020.106175 | spa |
| dc.relation.references | 31. EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol [Internet]. 2016;64(6):1388–402. Disponible en: http://dx.doi.org/10.1016/j.jhep.2015.11.004 | spa |
| dc.relation.references | 32. kstedt M, Franzen LE, Mathiesen UL, Thorelius L, Holmqvist M, Bodemar G, Kechagias S. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology 2006;44:865–73. https://doi.org/10.1002/hep.21327 | spa |
| dc.relation.references | 33. Rafiq N, Bai C, Fang Y, Srishord M, McCullough A, Gramlich T, Younossi ZM. Long- term follow-up of patients with nonalcoholic fatty liver. Clin Gastroenterol Hepatol 2009;7:234–8. https://doi.org/10.1016/j.cgh.2008.11.005 | spa |
| dc.relation.references | 34. Huh Y, Cho YJ, Nam GE. Recent epidemiology and risk factors of nonalcoholic fatty liver disease. J Obes Metab Syndr 2022;31:17–27 | spa |
| dc.relation.references | 35. Sookoian S, Pirola CJ. Meta-analysis of the influence of I148M variant of patatin-like phospholipase domain containing 3 gene (PNPLA3) on the susceptibility and histological severity of nonalcoholic fatty liver disease. Hepatology 2011;53:1883–94 | spa |
| dc.relation.references | 36. Montemayor S, Mascaro CM, Ugarriza L, Casares M, Llompart I, Abete I, et al. Adherence to mediterranean diet and NAFLD in patients with metabolic syndrome: the FLIPAN study. Nutrients 2022;14. https://doi.org/10.3390/nu14153186 | spa |
| dc.relation.references | 37. van der Heijden GJ, Wang ZJ, Chu ZD, Sauer PJ, Haymond MW, Rodriguez LM, et al. A 12-week aerobic exercise pro- gram reduces hepatic fat accumulation and insulin resistance in obese, Hispanic adolescents. Obesity Silver Spring 2010; 18:384-90 | spa |
| dc.relation.references | 38. Devries MC, Samjoo IA, Hamadeh MJ, Tarnopolsky MA. Effect of endurance exercise on hepatic lipid content, enzymes, and adiposity in men and women. Obesity Silver Spring 2008;16:2281-8 | spa |
| dc.relation.references | 39. Li J, Zou B, Yeo YH, Feng Y, Xie X, Lee DH, et al. Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999-2019: a systematic review and meta-analysis. Lan- cet Gastroenterol Hepatol 2019;4:389-98 | spa |
| dc.relation.references | 40. Rocha PM, Barata JT, Minderico CS, Silva AM, Teixeira PJ, Sardinha LB. Visceral abdominal and subfascial femoral adi- pose tissue have opposite associations with liver fat in over- weight and obese premenopausal caucasian women. J Lipids 2011;2011:154672 | spa |
| dc.relation.references | 41. Khan RS, Bril F, Cusi K, Newsome PN. Modulation of insulin resistance in nonalcoholic fatty liver disease. Hepatology 2019;70:711–24 | spa |
| dc.relation.references | 42. Schult A, Eriksson H, Wallerstedt S, Kaczynski J. Overweight and hypertriglyceridemia are risk factors for liver cirrhosis in middle-aged Swedish men. Scand J Gastroenterol 2011;46: 738-44 | spa |
| dc.relation.references | 43. Ruscica M, Ferri N, Macchi C, Meroni M, Lanti C, Ricci C, et al. Liver fat accumulation is associated with circulating PCSK9. Ann Med 2016;48:384–91 | spa |
| dc.relation.references | 44. Kamal S, Khan MA, Seth A, Cholankeril G, Gupta D, Singh U, et al. Beneficial effects of statins on the rates of hepatic fibrosis, hepatic decompensation, and mortality in chronic liver disease: a systematic review and meta-analysis. Am J Gastro- enterol 2017;112:1495-505 | spa |
| dc.relation.references | 45. Li Y, Yang P, Ye J, Xu Q, Wu J, Wang Y. Updated mechanisms of MASLD pathogenesis. Lipids Health Dis [Internet]. 2024;23(1). Disponible en: http://dx.doi.org/10.1186/s12944-024-02108-x | spa |
| dc.relation.references | 46. Quek J, Chan KE, Wong ZY, Tan C, Tan B, Lim WH, et al. Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2023;8:20–30. https://doi.org/10.1016/ S2468-1253(22)00317-X | spa |
| dc.relation.references | 47. Friedman SL, Neuschwander-Tetri BA, Rinella M, Sanyal AJ. Mechanisms of NAFLD development and therapeutic strategies. Nat Med 2018;24:908–22 | spa |
| dc.relation.references | 48. Softic, S., Cohen, D. E. & Kahn, C. R. Role of dietary fructose and hepatic de novo lipogenesis in fatty liver disease. Dig. Dis. Sci. 2016; 61, 1282–1293.) 49. Szabo G, Petrasek J. Inflammasome activation and function in liver disease. Nat Rev Gastroenterol Hepatol2015;12:387 400 | spa |
| dc.relation.references | 50. Bashiardes S, Shapiro H, Rozin S, Shibolet O, Elinav E. Non-alcoholic fatty liver and the gut microbiota. MolMetab 2016;5:782–94 | spa |
| dc.relation.references | 51. Hydes T, Brown E, Hamid A, Bateman AC, Cuthbertson DJ. Current and emerging biomarkers and imaging modalities for nonalcoholic fatty liver disease: Clinical and research applications. Clin Ther 2021;43:1505–22 | spa |
| dc.relation.references | 52. Sanyal AJ, Castera L, Wong VW-S. Noninvasive assessment of liver fibrosis in NAFLD. Clin Gastroenterol Hepatol [Internet]. 2023;21(8):2026–39. Disponible en: http://dx.doi.org/10.1016/j.cgh.2023.03.042 | spa |
| dc.relation.references | 53. Lonardo A, Nascimbeni F, Maurantonio M, Marrazzo A, Rinaldi L, Adinolfi LE. Nonalcoholic fatty liver disease: Evolving paradigms. World J Gastroenterol 2017;23:6571–92 | spa |
| dc.relation.references | Jennison E, Patel J, Scorletti E, Byrne CD. Diagnosis and management of non-alcoholic fatty liver disease. Postgrad Med J 2019;95:314–22 | spa |
| dc.relation.references | 55. Promrat K, Kleiner DE, Niemeier HM, et al. Randomized controlled trial testing the effects of weight loss on non55. Promrat K, Kleiner DE, Niemeier HM, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology. 2010;51(1):121-129.alcoholic steatohepatitis. Hepatology. 2010;51(1):121-129 | spa |
| dc.relation.references | 56. Zeng J, Fan J-G, Francque SM. Therapeutic management of metabolic dysfunction associated steatotic liver disease. United European Gastroenterol J [Internet]. 2024;12(2):177–86. Disponible en: http://dx.doi.org/10.1002/ueg2.12525 | spa |
| dc.relation.references | 57. Manzano-Nunez R, Rivera-Esteban J, Comas M, Angel M, Flores V, Bañares J, et al. Outcomes of patients with severe obesity and cirrhosis with portal hypertension undergoing bariatric surgery: A systematic review. Obes Surg [Internet]. 2023;33(1):224–33. Disponible en: http://dx.doi.org/10.1007/s11695-022-06362-9 | spa |
| dc.relation.references | 58. Saruar, A. Neaz, H. Hussain, S. Hossain, F. Rahman, T. Diabetes Mellitus: Insights from Epidemiology, Biochemistry, Risk Factors, Diagnosis, Complications and Comprehensive Management. Diabetology. 2021. 2. 36-50 | spa |
| dc.relation.references | 59. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 2. Classification and diagnosis of diabetes: Standards of care in diabetes-2023. Diabetes Care 2023;46:S19–40 | spa |
| dc.relation.references | 60. Mancia Chairperson G, Kreutz Co-Chair R, Brunström M, Burnier M, Grassi G, Januszewicz A, et al. 2023 | spa |
| dc.relation.references | 61. ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH). J Hypertens 2023;Publish Ahead of Print | spa |
| dc.relation.references | 62. Obesity. Who.int s/f. https://www.who.int/health-topics/obesity (consultado el 19 de agosto de 2023 | spa |
| dc.relation.references | 63. Durrington P. Dyslipidaemia. Lancet 2003;362:717–31 | spa |
| dc.relation.references | 64. Civeira F, Arca M, Cenarro A, Hegele RA. A mechanism-based operational definition and classification of hypercholesterolemia. J Clin Lipidol 2022;16:813–21 | spa |
| dc.relation.references | 65. Anthony PP, Ishak KG, Nayak NC, Poulsen HE, Scheuer PJ, Sobin LH. The morphology of cirrhosis: definition, nomenclature, and classification. Bull World Health Organ 1977;55:521–40 | spa |
| dc.relation.references | 66. Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, Kamath PS. Liver cirrhosis. Lancet 2021;398:1359–76 | spa |
| dc.relation.references | 67. Mired Barranquilla IPS s/f. https://miredbarranquilla.com/ (consultado el 15 de junio de 2023 | spa |
| dc.relation.references | 68. Guerrero-Bermúdez, C. A., Villa-Pérez, S., Arteta-Cueto, A. A., Pérez-Cadavid, J. C., & Jaimes-Barragán, F. (2024). Evaluación del desempeño de tres puntajes no invasivos para el diagnóstico de fibrosis avanzada en una población con hígado graso no alcohólico. Hepatología, 5(2), 137–147. https://doi.org/10.59093/27112330.113 | spa |
| dc.relation.references | 69. Bornacelly AP, Castillo O. caracterización de hígado graso metabólico y su asociación con desenlaces cardiovasculares mayores no fatales en pacientes diabéticos tipo 2 atendidos de forma ambulatoria en barranquilla durante julio a diciembre de 2021. repositorio institucional unilibre | spa |
| dc.relation.references | 49. Szabo G, Petrasek J. Inflammasome activation and function in liver disease. Nat Rev Gastroenterol Hepatol2015;12:387 400 | spa |
| dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
| dc.rights.coar | http://purl.org/coar/access_right/c_abf2 | spa |
| dc.rights.license | Atribución-NoComercial-SinDerivadas 2.5 Colombia | spa |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/2.5/co/ | spa |
| dc.subject | Esteatosis hepática asociada a disfunción metabólica MASLD | spa |
| dc.subject | Enfermedad por hígado graso no alcohólica EHGNA | spa |
| dc.subject | Prevalencia | spa |
| dc.subject | Factores de riesgo | spa |
| dc.subject | Epidemiología | spa |
| dc.subject.lemb | Hígado graso | spa |
| dc.subject.lemb | Enfermedades hepáticas | spa |
| dc.subject.lemb | Factores de riesgo | spa |
| dc.subject.lemb | Prevalencia | spa |
| dc.subject.subjectenglish | Hepatic steatosis associated with metabolic dysfunction MASLD | spa |
| dc.subject.subjectenglish | Non-alcoholic fatty liver disease NAFLD | spa |
| dc.subject.subjectenglish | Prevalence | spa |
| dc.subject.subjectenglish | Risk factors | spa |
| dc.subject.subjectenglish | Epidemiology | spa |
| dc.title | Identificación de características sociodemográficas, medidas antropométricas y comorbilidades en personas con enfermedad hepática esteatósica asociada a disfunción metabólica atendidos en el servicio de consulta externa en Mi Red IPS entre enero de 2021 y diciembre de 2022 | spa |
| dc.type.coar | http://purl.org/coar/resource_type/c_7a1f | spa |
| dc.type.driver | info:eu-repo/semantics/bachelorThesis | spa |
| dc.type.hasversion | info:eu-repo/semantics/acceptedVersion | spa |
| dc.type.local | Tesis de Especialización | spa |
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