Browsing by Author "Barrera, Francisco"

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    Disparities in steatosis prevalence in the United States by Race or Ethnicity according to the 2023 criteria
    (2024) Díaz, Luis Antonio; Lazarus, Jeffrey V.; Fuentes López, Eduardo; Idalsoaga Ferrer, Francisco Javier; Ayares Campos, Gustavo Ignacio; Desaleng, Hailemichael; Danpanichkul, Pojsakorn; Cotter, Thomas G.; Dunn, Winston; Barrera, Francisco; Wijarnpreecha, Karn; Noureddin, Mazen; Alkhouri, Naim; Singal, Ashwani K.; Wong, Robert J.; Younossi, Zobair M.; Rinella, Mary E.; Kamath, Patrick S.; Bataller, Ramon; Loomba, Rohit; Arrese Jiménez, Marco; Arab Verdugo, Juan Pablo
    © The Author(s) 2024.Introduction: The 2023 nomenclature defined criteria for steatotic liver disease (SLD), including metabolic dysfunction-associated SLD (MASLD), alcohol-associated liver disease (ALD), and the overlapping MASLD/ALD (MetALD). We aimed to assess racial and ethnic disparities in the SLD prevalence among United States (US) adults based on this new nomenclature. Methods: We undertook a cross-sectional study employing the 2017–2018 National Health and Nutrition Examination Survey (NHANES) database. We identified SLD according to a controlled attenuation parameter ≥288 dB/m, liver stiffness ≥7.2 kPa, or elevated aminotransferase levels. Alcohol use thresholds were established according to the updated SLD definition. We estimated prevalences using the complex design of the NHANES survey. Multivariable logistic regressions with complex design weights were employed. Results: A total of 5532 individuals are included. The mean age is 45.4 years, and 50.9% are women. The adjusted estimated prevalence of MASLD is 42.4% (95% CI: 41.1–43.8%), MetALD 1.7% (95% CI: 1.3–2.0%), and ALD 0.6% (95% CI: 0.3–0.8%). Hispanics exhibit a higher prevalence of SLD, but there are no significant differences in advanced fibrosis prevalence due to SLD among racial/ethnic groups. In MASLD, men, individuals aged 40–64 and ≥65 years, Hispanics, those with health insurance, higher BMI, diabetes, hypertension, hypertriglyceridemia, and low high-density lipoprotein (HDL) cholesterol or use of lipid-lowering agents are independently associated with a higher risk, while Blacks have the lowest risk. In MetALD, men and higher BMI are independently associated with a higher risk of MetALD in adjusted multivariable analysis. In ALD, the adjusted multivariable analysis shows that only health insurance is independently associated with a lower ALD risk. Conclusions: MASLD prevalence is high in the US, especially in men, older individuals, and Hispanics. MetALD and ALD prevalence was substantial but could be underestimated.
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    Mineralocorticoid receptor modulation by dietary sodium influences NAFLD development in mice
    (ELSEVIER ESPANA, 2021) Cabrera, Daniel; Rao, Isabel; Raasch, Fabiola; Solis, Nancy; Pizarro, Margarita; Freire, Mariela; De Urturi, Diego Saenz; Ramirez, Carolina A.; Triantafilo, Nicolas; Leon, Jonathan; Riquelme, Arnoldo; Barrera, Francisco; Baudrand, Rene; Aspichueta, Patricia; Arrese, Marco; Arab, Juan P.
    Introduction and Objectives: Nonalcoholic-fatty-liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome (MetS). Mineralocorticoid receptor (MR) activation is associated with increased risk of MetS but few studies have assessed the role of liver MR on NAFLD. We aimed to evaluate the effect of MR modulation by sodium intake in liver injury in experimental models of NAFLD.
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    Platelet count/spleen diameter ratio for non-invasive prediction of high risk esophageal varices in cirrhotic patients
    (ELSEVIER ESPANA, 2009) Barrera, Francisco; Riquelme, Arnoldo; Soza, Alejandro; Contreras, Alvaro; Barrios, Gerty; Padilla, Oslando; Viviani, Paola; Maria Perez Ayuso, Rosa
    Background and objective. Prophylaxis therapy is indicated in cirrhotic patients with large esophageal varices or small varices with red wale signs (high risk esophageal varices; HREV). Endoscopic surveillance to detect HREV is currently recommended. The objective of this study is to identify non-invasive predictors of HREV in cirrhotic patients. Design and methods. Adult cirrhotic patients without previous variceal bleeding were prospectively included. All patients underwent a complete biochemical workup, upper digestive endoscopy, and ultrasonographic measurement of spleen bipolar diameter. Platelet count/spleen diameter ratio (PC/SD) was calculated for all patients. The association of these variables with the presence of HREV in upper endoscopy was tested using univariate and multivariate analysis. Receiver operating characteristic (ROC) curves were constructed for variables associated with HREV. Results. Sixty-seven patients were included. The prevalence rate of HREV was 50%. Age, gender (female), platetet count, spleen diameter, PC/SD ratio, total bilirrubin, prothrombin activity (INR), Childl-Pugh score, clinical and ultrasonographic ascites were significantly associated with presence of HREV in univariate analysis. Age and PC/SD ratio were the parameters independently associated with HREV in a multivariate analysis, with OR 8.81 (CI 95%: 1.7-44.9) and OR 11.21 (CI 95%: 2.8-44.6) respectively. A PC/SD ratio cut-off value under 830.8 predicted HREV with 76.9% sensitivity, 74.2% specificity and 77.8% negative predictive value (ROC curve area: 0.78). Conclusions. The PC/SD ratio was significantly associated with HREV, but with suboptimal sensitivity and specificity. Therefore, the results of this study do not support the routine clinical use of PC/SD ratio for screening of HREV.
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    Prevalence of Advanced Liver Fibrosis and Nonalcoholic Steato-hepatitis Diagnosed by Noninvasive Methods in Chilean Type 2 Diabetic Patients
    (2014) Gallego, Consuelo; Valderas, Juan P.; Uribe, Sergio; Tejos, Cristian; Serrano, Cristobal; Huete, Alvaro; Barrera, Francisco; Liberona, Jessica; Labbe, Pilar; Quiroga, Teresa; Irarrazabal, Pablo; Arrese, Marco
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    Quantification of visceral adipose tissue using magnetic resonance imaging compared with anthropometry, in type 2 diabetic patients
    (SOC MEDICA SANTIAGO, 2012) Serrano Garcia, Cristobal; Barrera, Francisco; Labbe, Pilar; Liberona, Jessica; Arrese, Marco; Irarrazaval, Pablo; Tejos, Cristian; Uribe, Sergio
    Background: Visceral fat accumulation is associated with the development of metabolic diseases. Anthropometry is one of the methods used to quantify it. aim: to evaluate the relationship between visceral adipose tissue volume (VAT), measured with magnetic resonance imaging (MRI), and anthropometric indexes, such as body mass index (BMI) and waist circumference (WC), in type 2 diabetic patients (DM2). Patients and Methods: Twenty four type 2 diabetic patients aged 55 to 78 years (15 females) and weighting 61.5 to 97 kg, were included. The patients underwent MRI examination on a Philips Intera (R) 1.5T MR scanner. The MRI protocol included a spectral excitation sequence centered at the fat peak. The field of view included from L4-L5 to the diaphragmatic border. VAT was measured using the software Image J (R). Weight, height, BMI, WC and body fat percentage (BF%), derived from the measurement of four skinfolds with the equation of Durnin and Womersley, were also measured. The association between MRI VAT measurement and anthropometry was evaluated using the Pearson's correlation coefficient. Results: Mean VAT was 2478 +/- 758 ml, mean BMI 29.5 +/- 4.7 kg/m(2), and mean WC was 100 +/- 9.7 cm. There was a poor correlation between VAT, BMI (r = 0.18) and WC (r = 0.56). Conclusions: BMI and WC are inaccurate predictors of VAT volume in type 2 diabetic patients. (Rev Med Chile 2012; 140: 1535-1543).