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

Vista sencilla de ítem
dc.contributor.advisorCano Peñaloza, Raquel Amira
dc.contributor.advisorMoreno Pallares, Eiman
dc.contributor.advisorVarela Prieto, Lourdes
dc.contributor.authorBornacelly Mendoza, Adriana Paola
dc.contributor.authorCastillo Nevado, Oswaldo Jesús
dc.coverage.spatialBarranquillaspa
dc.creator.emailadrianap-bornacellym@unilibre.edu.cospa
dc.creator.emailoswaldode-castillon@unilibre.edu.cospa
dc.date.accessioned2023-12-13T21:01:13Z
dc.date.available2023-12-13T21:01:13Z
dc.date.created2023
dc.description.abstractEl objetivo es caracterizar el espectro de la enfermedad por hígado graso no alcohólico de causa metabólica (EHGNA) y su asociación con desenlaces cardiovasculares mayores no fatales en pacientes adultos con diagnóstico de Diabetes Mellitus tipo 2 atendidos de forma ambulatoria en Barranquilla-Colombia de julio a diciembre de 2021. Se realizó una estudio observacional descriptivo documental con revisión de historias clínicas de corte retrospectiva con un componente analítico entre EHGNA en pacientes diabéticos y desenlaces cardiovasculares mayores no fatales. Se incluyeron 309 personas con diabetes atendidos en dos instituciones de referencia en Barranquilla: la Clínica General del Norte (CGN, n=162) y MiRed IPS (n=147), la prevalencia global de EHGNA fue del 67%, la esteatosis correspondió a un 50,81% (n=157), la esteatosis con algún grado de fibrosis ya sea significativa o avanzada se encontró en el 3,88% (n=12) y la cirrosis en el 12% (n=38), aportando una prevalencia global de fibrosis del 16,18% (n=50). La ecografía fue el estudio imagenológico más empleado para la detección y diagnóstico de esteatosis, la elastografía transitoria se realizó solo en 54 pacientes (17,48%). La prevalencia de obesidad en pacientes con diabetes y EHGNA fue del 36,82%, siendo la obesidad grado 1 la categoría más frecuente, la hipertensión arterial se presentó en el 76,33% de los casos, la dislipidemia en el 73,43%. Se encontró una mayor proporción de desenlaces cardiovasculares mayores no fatales como síndrome coronario agudo y fibrilación auricular en los pacientes con EHGNA (OR: 1,94; 95% IC:1,05-3,66; p=0.04). la conclusión es que la prevalencia de EHGNA en pacientes diabéticos atendidos en Barranquilla es del 67%, la prevalencia de fibrosis fue del 16,18%; además se observó una tendencia con efecto de riesgo con una mayor proporción de desenlaces cardiovasculares mayores no fatales como síndrome coronario agudo y fibrilación auricular en los pacientes con EHGNA (OR: 1,94; 95% IC:1,05-3,66; p=0.04) por lo que se requieren estudios analíticos adicionales que profundicen en el efecto de riesgo de EHGNA en la morbilidad cardiovascular.spa
dc.description.abstractenglishThe Objective is To characterize the spectrum of metabolic nonalcoholic fatty liver disease (NAFLD) and its association with cardiovascular morbidity in adult patients diagnosed with type 2 Diabetes Mellitus treated on an outpatient basis in Barranquilla-Colombia from July to December 2021. A descriptive observational documentary study was conducted with a retrospective medical record review with an analytical component between NAFLD in diabetic patients and non-fatal primary cardiovascular outcomes. The study included 309 people with diabetes treated in two referral institutions in Barranquilla, the Clínica General del Norte (CGN, n=162) and MiRed IPS (n=147): Clínica General del Norte (CGN, n=162) and MiRed IPS (n=147), the overall prevalence of NAFLD was 67%, steatosis corresponded to 50.81% (n=157), steatosis with some degree of fibrosis either significant or advanced was found in 3.88% (n=12) and cirrhosis in 12% (n=38), contributing an overall prevalence of fibrosis of 16.18% (n=50). Ultrasonography was the most commonly used imaging study for detecting and diagnosing steatosis; transient elastography was performed only in 54 patients (17.48%). The prevalence of obesity in patients with diabetes and NAFLD was 36.82%, with grade 1 obesity being the most frequent category, arterial hypertension was present in 76.33% of cases, and dyslipidemia in 73.43%. A higher proportion of non-fatal primary cardiovascular outcomes, such as acute coronary syndrome and atrial fibrillation, was found in patients with NAFLD (OR: 1.94; 95% CI: 1.05-3.66; p=0.04). the Conclusions is the prevalence of NAFLD in diabetic patients attended in Barranquilla is 67%, the prevalence of fibrosis was 16.18%; furthermore, a trend with risk effect was observed with a higher proportion of non-fatal primary cardiovascular outcomes such as acute coronary syndrome and atrial fibrillation in patients with NAFLD (OR: 1.94; 95% CI:1.05-3.66; p=0.04) so further analytical studies are required to delve into the risk effect of NAFLD on cardiovascular morbidity.spa
dc.description.sponsorshipUniversidad Libre Seccional Barranquilla -- Facultad de Ciencias de la Salud -- Especialización en Medicina Internaspa
dc.formatPDFspa
dc.identifier.urihttps://hdl.handle.net/10901/27874
dc.relation.referencesEslam M, Sanyal AJ, George J, Sanyal A, Neuschwander-Tetri B, Tiribelli C, et al. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease. Gastroenterology. 2020;158(7):1999-2014.e1spa
dc.relation.referencesAnstee QM, Targher G, Day CP. Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. Vol. 10, Nature Reviews Gastroenterology and Hepatology. 2013. p. 330–44spa
dc.relation.referencesStine JG, Wentworth BJ, Zimmet A, Rinella ME, Loomba R, Caldwell SH, et al. Systematic review with meta-analysis: risk of hepatocellular carcinoma in non-alcoholic steatohepatitis without cirrhosis compared to other liver diseases. Alimentary Pharmacology and Therapeutics 2018; 48(7):696-703spa
dc.relation.referencesCaussy C, Aubin A, Loomba R. The Relationship Between Type 2 Diabetes, NAFLD, and Cardiovascular Risk. Current Diabetes Reports 2021; 21 (5):15spa
dc.relation.referencesKaya E, Yilmaz Y. Metabolic-associated Fatty Liver Disease (MAFLD): A Multi-systemic Disease Beyond the Liver. Journal of Clinical and Translational Hepatology 2022; 10 (2); 329-338spa
dc.relation.referencesYounossi ZM, Golabi P, Paik JM, Henry A, Van Dongen C, Henry L. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023;77(4):1335–47spa
dc.relation.referencesHuang DQ, El-Serag HB, Loomba R. Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention. Nature Reviews Gastroenterology and Hepatology 2021; 18 (4): 223-238spa
dc.relation.referencesYounossi ZM. Non-alcoholic fatty liver disease – A global public health perspective. Journal of Hepatology 2019; 70 (3): 531-544spa
dc.relation.referencesCusi K, Isaacs S, Barb D, Basu R, Caprio S, Garvey WT, et al. American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver 54 Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocrine Practice. 2022;28(5):528–62spa
dc.relation.referencesRinella ME, Neuschwander-Tetri BA, Shadab Siddiqui M, Abdelmalek MF, Caldwell S, Barb D, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023; 77:1797–835spa
dc.relation.referencesTargher G, Byrne CD, Tilg H. NAFLD and increased risk of cardiovascular disease: Clinical associations, pathophysiological mechanisms and pharmacological implications. Gut 2020; 69 (9): 1691-1705spa
dc.relation.referencesChalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328-357spa
dc.relation.referencesChen X, Ma T, Yip R, Perumalswami P V., Branch AD, Lewis S, et al. Elevated prevalence of moderate-tosevere hepatic steatosis in World Trade Center General Responder Cohort in a program of CT lung screening. Clin Imaging. 2020;60(2):237–43spa
dc.relation.referencesChen X, Li K, Yip R, Perumalswami P, Branch AD, Lewis S, et al. Hepatic steatosis in participants in a program of low-dose CT screening for lung cancer. Eur J Radiol. 2017; 94:174–9spa
dc.relation.referencesBoyce CJ, Pickhardt PJ, Kim DH, Taylor AJ, Winter TC, Bruce RJ, et al. Hepatic steatosis (fatty liver disease) in asymptomatic adults identified by unenhanced low-dose CT. American Journal of Roentgenology. 2010;194(3):623–8spa
dc.relation.referencesOchoa C. E, Calambás F. Hígado graso no alcohólico en consulta de gastroenterología. Repertorio de Medicina y Cirugía. 2017;26(4):225–30spa
dc.relation.referencesPrieto Ortiz JE, Pardo SS, Díaz LR, Pacheco SH. Hígado graso: Aspectos clínicos en un centro de tercer nivel en Bogotá - Período 2009-2013. Rev Colomb Gastroenterol. 2014;29(2):117–24spa
dc.relation.referencesVanegas R. CM, Restrepo R. C, Vargas G. N, Marín C. AE, Martínez S. LM, Yepes D. CE, et al. Characterization of patients with non-alcoholic fatty liver disease in a highly complex colombian hospital in 2013. Rev Colomb Gastroenterol. 2014;29(4):342–6spa
dc.relation.referencesEscorcia E;, Marrugo W. Caracterización epidemiológica y clínica de la cirrosis hepatica en un centro regional del caribe colombiano: clínica general del norte. Enero 2012 a marzo 2017. Biociencias. 2018;13(1):17–30spa
dc.relation.referencesTargher G, Corey KE, Byrne CD. NAFLD, and cardiovascular and cardiac diseases: Factors influencing risk, prediction and treatment. Diabetes and Metabolism 2021; 47 (2): 101215spa
dc.relation.referencesBejarano Ramírez DF, Carrasquilla Gutiérrez G, Porras Ramírez A, Vera Torres A. Prevalence of liver disease in Colombia between 2009 and 2016. JGH Open 2020; 4: 603-610spa
dc.relation.referencesPrieto O JE, Sánchez P S, Prieto RG, Rojas D EL, González L, Mendivelso F. Características clínicas y descompensación en pacientes con cirrosis hepática atendidos en dos centros de hepatología en la ciudad de Bogotá D.C., 2010-2014. Revista Colombiana De Gastroenterología 2016; 31(1): 1–8spa
dc.relation.referencesGiraldo-Montoya Ángela M., Barraza-Amador M, Villa-Velásquez H, Martínez JW, Garcia-Castro G. Caracterización epidemiológica de pacientes con cirrosis en una consulta de gastroenterología en Pereira, Colombia, 2009-2012. Rev Méd Risaralda 2014; 20 (2):8686-94spa
dc.relation.referencesLambis L, Belisario Solana J, Gastelbondo B, Romero D, Garrido D, Puello W, et al. Factores de riesgo asociados a hígado graso de origen no alcohólico en una población del Caribe Colombiano. Rev Col Gastroenterol 2016; 31 (2): 89-95spa
dc.relation.referencesPowell EE, Wong VWS, Rinella M. Non-alcoholic fatty liver disease. The Lancet 2021; 397: 2212–24. Elsevier B.Vspa
dc.relation.referencesPerez M, Gonzáles L, Olarte R, Rodríguez NI, Tabares M, Salazar JP, et al. Nonalcoholic fatty liver disease is associated with insulin resistance in a young Hispanic population. Prev Med (Baltim). 2011;52(2):174– 7spa
dc.relation.referencesLópez-Velázquez JA, Silva-Vidal K V., Ponciano-Rodríguez G, Chávez-Tapia NC, Arrese M, Uribe M, et al. The prevalence of nonalcoholic fatty liver disease in the Americas. Annals of Hepatology 2014;13(2):166-78spa
dc.relation.referencesRojas YAO, Cuellar CLV, Barrón KMA, Arab JP, Miranda AL. Non-alcoholic fatty liver disease prevalence in Latin America: A systematic review and meta-analysis. Annals of Hepatology 2022; 27(6):100706spa
dc.relation.referencesBudd J, Cusi K. Nonalcoholic Fatty Liver Disease: What Does the Primary Care Physician Need to Know? American Journal of Medicine 2020;133(5):536-543spa
dc.relation.referencesPadda J, Khalid K, Khedr A, Tasnim F, Al-Ewaidat OA, Cooper AC, et al. Non-Alcoholic Fatty Liver Disease and Its Association With Diabetes Mellitus. Cureus. 2021;13(8): e17321spa
dc.relation.referencesDokmak A, Lizaola-Mayo B, Trivedi HD. The Impact of Nonalcoholic Fatty Liver Disease in Primary Care: A Population Health Perspective. American Journal of Medicine 2021; 134 (1): 23-29. Elsevier Incspa
dc.relation.referencesYounossi Z, Anstee QM, Marietti M, Hardy T, Henry L, Eslam M, et al. Global burden of NAFLD and NASH: Trends, predictions, risk factors and prevention. Nature Reviews Gastroenterology and Hepatology 2018; 15(1):11-20. Nature Publishing Groupspa
dc.relation.referencesZheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology 2018; 14 (2): 88-98spa
dc.relation.referencesRadaelli MG, Martucci F, Perra S, Accornero S, Castoldi G, Lattuada G, et al. NAFLD/NASH in patients with type 2 diabetes and related treatment options. Journal of Endocrinological Investigation 2018; 41(5): 509-521spa
dc.relation.referencesGlovaci D, Fan W, Wong ND. Epidemiology of Diabetes Mellitus and Cardiovascular Disease. Current Cardiology Reports 2019; 21 (4): 21spa
dc.relation.referencesVargas-Uricoechea H, Casas-Figueroa LÁ. An Epidemiologic Analysis of Diabetes in Colombia. Annals of Global Health 2015;81(6):742-53spa
dc.relation.referencesRoth GA, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Erratum: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet 2018; 392(10160):1736- 1788spa
dc.relation.referencesYounossi ZM, Felix S, Jeffers T, Younossi E, Lam B, Nader F, et al. Serum Biomarkers are Associated With Atherosclerotic Cardiovascular Disease Among Patients With Nonalcoholic Fatty Liver Disease Undergoing Elective Angiography. Clinical Gastroenterology and Hepatology 2022; 20(5): e1149-e1156spa
dc.relation.referencesDuell PB, Welty FK, Miller M, Chait A, Hammond G, Ahmad Z, et al. Nonalcoholic Fatty Liver Disease and Cardiovascular Risk: A Scientific Statement From the American Heart Association. Arteriosclerosis, thrombosis, and vascular biology 2022;42(6): e168-e185spa
dc.relation.referencesZhou YY, Zhou XD, Wu SJ, Fan DH, Van Poucke S, Chen YP, et al. Nonalcoholic fatty liver disease contributes to subclinical atherosclerosis: A systematic review and meta-analysis. Hepatology Communications 2018; 2(4):376-392spa
dc.relation.referencesMotamed N, Rabiee B, Poustchi H, Dehestani B, Hemasi GR, Khonsari MR, et al. Non-alcoholic fatty liver disease (NAFLD) and 10-year risk of cardiovascular diseases. Clin Res Hepatol Gastroenterol. 2017;41(1):31–8spa
dc.relation.referencesLee SB, Park GM, Lee JY, Lee BU, Park JH, Kim BG, et al. Association between non-alcoholic fatty liver disease and subclinical coronary atherosclerosis: An observational cohort study. J Hepatol. 2018;68(5):1018–24spa
dc.relation.referencesTargher G, Byrne CD, Lonardo A, Zoppini G, Barbui C. Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: A meta-analysis. J Hepatol. 2016;65(3):589–600spa
dc.relation.referencesAssy N, Djibre A, Farah R, Grosovski M, Marmor A. Presence of coronary plaques in patients with nonalcoholic fatty liver disease. Radiology. 2010;254(2):393–400spa
dc.relation.referencesChoi DH, Lee SJ, Kang CD, Park MO, Choi DW, Kim TS, et al. Nonalcoholic fatty liver disease is associated with coronary artery disease in Koreans. World Journal of Gastroenterology 2013; 19(38): 6453–6457spa
dc.relation.referencesPerera N, Indrakumar J, Abeysinghe WV, Fernando V, Samaraweera WMCK, Lawrence JS. Non alcoholic fatty liver disease increases the mortality from acute coronary syndrome: An observational study from Sri Lanka. BMC Cardiovasc Disord. 2016;16(1):37spa
dc.relation.referencesMahfood Haddad T, Hamdeh S, Kanmanthareddy A, Alla VM. Nonalcoholic fatty liver disease and the risk of clinical cardiovascular events: A systematic review and meta-analysis. Diabetes and Metabolic Syndrome: Clinical Research and Reviews 2017; 11 Suppl 1: S209-S216spa
dc.relation.referencesKeskin M, Hayıroğlu Mİ, Uzun AO, Güvenç TS, Şahin S, Kozan Ö. Effect of Nonalcoholic Fatty Liver Disease on In-Hospital and Long-Term Outcomes in Patients With ST–Segment Elevation Myocardial Infarction. American Journal of Cardiology. 2017;120(10):1720–6spa
dc.relation.referencesTsang SWC, Ng WF, Wu BPY, Chow DA, Li ETH, Wong TC. Predictors of fibrosis in Asian patients with non-alcoholic steatohepatitis. Journal of Gastroenterology and Hepatology (Australia). 2006;21(1 PART1):116–21spa
dc.relation.referencesKasper P, Martin A, Lang S, Kütting F, Goeser T, Demir M, et al. NAFLD and cardiovascular diseases: a clinical review. Clinical Research in Cardiology 2021; 110(7):921-937spa
dc.relation.referencesVasunta RL, Kesäniemi YA, Ylitalo AS, Ukkola OH. High ambulatory blood pressure values associated with non-alcoholic fatty liver in middle-aged adults. J Hypertens. 2012;30(10):2015–9spa
dc.relation.referencesAlkagiet S, Papagiannis A, Tziomalos K. Associations between nonalcoholic fatty liver disease and ischemic stroke. World Journal of Hepatology 2018; 10(7): 474–47spa
dc.relation.referencesAnstee QM, Mantovani A, Tilg H, Targher G. Risk of cardiomyopathy and cardiac arrhythmias in patients with nonalcoholic fatty liver disease. Nature Reviews Gastroenterology and Hepatology 2018;15(7):425- 439spa
dc.relation.referencesMantovani A, Pernigo M, Bergamini C, Bonapace S, Lipari P, Pichiri I, et al. Nonalcoholic fatty liver disease is independently associated with early left ventricular diastolic dysfunction in patients with type 2 diabetes. PLoS One. 2015;10(8): e0135329spa
dc.relation.referencesMantovani A, Pernigo M, Bergamini C, Bonapace S, Lipari P, Valbusa F, et al. Heart valve calcification in patients with type 2 diabetes and nonalcoholic fatty liver disease. Metabolism. 2015;64(8):879–87spa
dc.relation.referencesBonapace S, Valbusa F, Bertolini L, Pichiri I, Mantovani A, Rossi A, et al. Nonalcoholic fatty liver disease is associated with aortic valve sclerosis in patients with type 2 diabetes mellitus. PLoS One. 2014 Feb 5;9(2): e88371spa
dc.relation.referencesKäräjämäki AJ, Pätsi OP, Savolainen M, Kesäniemi YA, Huikuri H, Ukkola O. Non-alcoholic fatty liver disease as a predictor of atrial fibrillation in middle-aged population (OPERA study). PLoS One. 2015;10(11): e0142937spa
dc.relation.referencesMantovani A, Dauriz M, Sandri D, Bonapace S, Zoppini G, Tilg H, et al. Association between non-alcoholic fatty liver disease and risk of atrial fibrillation in adult individuals: An updated meta-analysis. Liver International. 2019;39(4):758-769spa
dc.relation.referencesLong MT, Yin X, Larson MG, Ellinor PT, Lubitz SA, McManus DD, et al. Relations of liver fat with prevalent and incident atrial fibrillation in the framingham heart study. J Am Heart Assoc. 2017;6(5): e005227spa
dc.relation.referencesLee SR, Han K Do, Choi EK, Oh S, Lip GYH. Nonalcoholic fatty liver disease and the risk of atrial fibrillation stratified by body mass index: a nationwide population-based study. Sci Rep. 2021;11(1):3737spa
dc.relation.referencesMarchesini G, Day CP, Dufour JF, Canbay A, Nobili V, Ratziu V, et al. EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64(6):1388-402spa
dc.relation.referencesGofton C, Upendran Y, Zheng MH, George J. MAFLD: How is it different from NAFLD? Clin Mol Hepatol. 2023;29(Suppl): S17–31spa
dc.relation.referencesSaavedra-Chacón MF, Pérez S, Guevara LG, Saavedra-Chacón MF, Pérez S, Guevara LG. Enfermedad del hígado graso asociada con la disfunción metabólica. Una nueva propuesta para una dolencia en auge. Iatreia. 2021;34(3):241–52spa
dc.relation.referencesPapatheodoridi M, Cholongitas E. Diagnosis of Non-alcoholic Fatty Liver Disease (NAFLD): Current Concepts. Curr Pharm Des. 2019;24(38):4574–86spa
dc.relation.referencesGraffigna M, Catoira N, Soutelo J, Azpelicueta A, Berg G, Perel C, et al. Diagnóstico de esteatosis hepática por métodos clínicos, bioquímicos y por imágenes. Rev Argent Endocrinol Metab. 2017;54(1):37–46spa
dc.relation.referencesWells MM, Li Z, Addeman B, Mckenzie CA, Mujoomdar A, Beaton M, et al. Computed Tomography Measurement of Hepatic Steatosis: Prevalence of Hepatic Steatosis in a Canadian Population. Can J Gastroenterol Hepatol. 2016; 2016:4930987spa
dc.relation.referencesCastera L, Yuen Chan HL, Arrese M, Afdhal N, Bedossa P, Friedrich-Rust M, et al. EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63(1):237-64spa
dc.relation.referencesBoyum JH, Atwell TD, Schmit GD, Poterucha JJ, Schleck CD, Harmsen WS, et al. Incidence and Risk Factors for Adverse Events Related to Image-Guided Liver Biopsy. Mayo Clin Proc. 2016;91(3):329–35spa
dc.relation.referencesStoopen-Rometti M, Encinas-Escobar ER, Ramirez-Carmona CR, Wolpert-Barraza E, Kimura-Hayama E, Sosa-Lozano LA, et al. Diagnóstico y cuantificación de fibrosis, esteatosis y hepatosiderosis por medio de resonancia magnética multiparamétrica. Revista de Gastroenterologia de Mexico 2017; 82(1):32-45spa
dc.relation.referencesSumida Y, Nakajima A, Itoh Y. Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Vol. 20, World Journal of Gastroenterology. 2014. p. 475–85spa
dc.relation.referencesCastellana M, Donghia R, Guerra V, Procino F, Lampignano L, Castellana F, et al. Performance of fatty liver index in identifying non-alcoholic fatty liver disease in population studies. A meta-analysis. J Clin Med. 2021;10(9):1877spa
dc.relation.referencesMartinou E, Pericleous M, Stefanova I, Kaur V, Angelidi AM. Diagnostic Modalities of Non-Alcoholic Fatty Liver Disease: From Biochemical Biomarkers to Multi-Omics Non-Invasive Approaches. Diagnostics. 2022;12(2):407spa
dc.relation.referencesRada G, Roa M. Qué son y cómo se interpretan los outcomes compuestos. Rev Med Chil. 2009;137(11):1523–6spa
dc.relation.referencesMach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. European Heart Journal 2020; 41:111-188spa
dc.relation.referencesElsayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2023. Diabetes Care 2023;46(Suppl 1):S158– S190spa
dc.relation.referencesElsayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes—2023. Diabetes Care 2023;46(Suppl 1): S49–S67spa
dc.relation.referencesSchattenberg JM, Allen AM, Jarvis H, Zelber-Sagi S, Cusi K, Dillon JF, et al. A multistakeholder approach to innovations in NAFLD care. Communications Medicine. 2023;3(1spa
dc.relation.referencesYounossi ZM, Golabi P, de Avila L, Paik JM, Srishord M, Fukui N, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis. J Hepatol. 2019;71(4):793–801spa
dc.relation.referencesDoycheva I, Cui J, Nguyen P, Costa EA, Hooker J, Hofflich H, et al. Non-invasive screening of diabetics in primary care for NAFLD and advanced fibrosis by MRI and MRE. Aliment Pharmacol Ther. 2016;43(1):83- 95spa
dc.relation.referencesAjmera V, Cepin S, Tesfai K, Hofflich H, Cadman K, Lopez S, et al. A prospective study on the prevalence of NAFLD, advanced fibrosis, cirrhosis and hepatocellular carcinoma in people with type 2 diabetes. J Hepatol. 2023;78(3):471–8spa
dc.relation.referencesKwok R, Choi KC, Wong GLH, Zhang Y, Chan HLY, Luk AOY, et al. Screening diabetic patients for nonAlcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: A prospective cohort study. Gut. 2016;65(8):1359–68spa
dc.relation.referencesCiardullo S, Perseghin G. Statin use is associated with lower prevalence of advanced liver fibrosis in patients with type 2 diabetes. Metabolism. 2021;121:154752spa
dc.relation.referencesRich NE, Oji S, Mufti AR, Browning JD, Parikh ND, Odewole M, et al. Racial and Ethnic Disparities in Nonalcoholic Fatty Liver Disease Prevalence, Severity, and Outcomes in the United States: A Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology. 2018;16(2):198-210.e2spa
dc.relation.referencesHan S, Choi M, Lee B, Lee HW, Kang SH, Cho Y, et al. Accuracy of Noninvasive Scoring Systems in Assessing Liver Fibrosis in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Gut Liver. 2022;16(6):952–63spa
dc.relation.referencesMózes FE, Lee JA, Selvaraj EA, Jayaswal ANA, Trauner M, Boursier J, et al. Diagnostic accuracy of noninvasive tests for advanced fibrosis in patients with NAFLD: An individual patient data meta-analysis. Gut 2022; 71:1006–1019spa
dc.relation.referencesSun W, Cui H, Li N, Wei Y, Lai S, Yang Y, et al. Comparison of FIB-4 index, NAFLD fibrosis score and BARD score for prediction of advanced fibrosis in adult patients with non-alcoholic fatty liver disease: A metaanalysis study. Hepatology Research 2016; 46(9):862-70spa
dc.relation.referencesPérez-Gutiérrez OZ, Hernández-Rocha C, Candia-Balboa RA, Arrese MA, Benítez C, Brizuela-Alcántara DC, et al. Validation study of systems for noninvasive diagnosis of fibrosis in nonalcoholic fatty liver disease in Latin population. Ann Hepatol. 2013;12(3):416–24spa
dc.relation.referencesAschner P, Gagliardino JJ, Ilkova H, Lavalle F, Ramachandran A, Mbanya JC, et al. Persistent poor glycaemic control in individuals with type 2 diabetes in developing countries: 12 years of real-world evidence of the International Diabetes Management Practices Study (IDMPS). Diabetologia. 2020;63(4):711–21spa
dc.relation.referencesHuayanay-Espinoza IE, Guerra-Castañon F, Lazo-Porras M, Castaneda-Guarderas A, Thomas NJ, GarciaGuarniz AL, et al. Metabolic control in patients with type 2 diabetes mellitus in a public hospital in Peru: A cross-sectional study in a lowmiddle income country. PeerJ. 2016;2016(10): e2577spa
dc.relation.referencesOsuna Pérez M, Rivera MC, Bocanegra C de J, Lancheros A, Tovar H, Hernández JI, et al. Caracterización de la diabetes mellitus tipo 2 y el control metabólico en el paciente hospitalizado. Acta Médica Colombiana. 2014;39(4):344–51spa
dc.relation.referencesMeyersohn NM, Mayrhofer T, Corey KE, Bittner DO, Staziaki P V., Szilveszter B, et al. Association of Hepatic Steatosis With Major Adverse Cardiovascular Events, Independent of Coronary Artery Disease. Clinical Gastroenterology and Hepatology. 2021;19(7):1480-1488.e14spa
dc.relation.referencesSimon TG, Roelstraete B, Hagström H, Sundström J, Ludvigsson JF. Non-alcoholic fatty liver disease and incident major adverse cardiovascular events: results from a nationwide histology cohort. Gut. 2022;71(9):1867–75spa
dc.relation.referencesIsmaiel A, Popa SL, Dumitrascu DL. Acute coronary syndromes and nonalcoholic fatty liver disease: “Un affaire de coeur.” Canadian Journal of Gastroenterology and Hepatology 2020; 30:8825615spa
dc.relation.referencesvan Kleef LA, Lu Z, Arfan Ikram M, de Groot NMS, Kavousi M, de Knegt RJ. Liver stiffness not fatty liver disease is associated with atrial fibrillation: The Rotterdam study. J Hepatol. 2022;77(4):931–8spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.subjectDiabetes mellitusspa
dc.subjectEnfermedad por hígado graso no alcohólico - EHGNAspa
dc.subjectFactor de riesgo cardiovascularspa
dc.subjectSíndrome coronario agudospa
dc.subjectFibrilación auricularspa
dc.subject.lembHígado grasospa
dc.subject.lembDiabetes mellitusspa
dc.subject.lembEnfermedades cardiovascularesspa
dc.subject.subjectenglishDiabetes mellitusspa
dc.subject.subjectenglishNon-alcoholic Fatty Liver Disease - NAFLDspa
dc.subject.subjectenglishHeart disease risk factorsspa
dc.subject.subjectenglishAcute coronary syndromespa
dc.subject.subjectenglishAtrial fibrillationspa
dc.titleCaracterización 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 2021spa
dc.type.driverinfo:eu-repo/semantics/bachelorThesisspa
dc.type.localTesis de Especializaciónspa

Archivos

Bloque original

Mostrando 1 - 2 de 2
Miniatura
Nombre:
BORNACELLY.pdf
Tamaño:
1.98 MB
Formato:
Adobe Portable Document Format
Descripción:
Archivo de Tesis MEDINT 2023
Descargar
Miniatura
Nombre:
FORMULARIO AUTORIZACION.pdf
Tamaño:
1.41 MB
Formato:
Adobe Portable Document Format
Descripción:
Descargar

Bloque de licencias

Mostrando 1 - 1 de 1
Miniatura
Nombre:
license.txt
Tamaño:
1.71 KB
Formato:
Item-specific license agreed upon to submission
Descripción:
Descargar

Colecciones

Especialización en Medicina Interna