ABSTRACT
La esteatosis hepática no alcohólica (EHNA) es la causa más frecuente de elevación de transaminasas en el adulto. OBJETIVOS: Determinar la prevalencia de EHNA en pacientes con hipertransaminasemia mantenida, y conocer el grado de adecuación del diagnóstico registrado en Atención Primaria (AP). MATERIAL Y MÉTODOS: 1) Estudio descriptivo transversal con muestra aleatoria de pacientes con elevación de la enzima alanina aminotransferasa (ALT) mantenida (ALT > 32 durante ≥ 6 meses), descartadas otras causas de hepatopatía, siguiendo criterios clínicos, analíticos y ecográficos en AP, y 2) descriptivo transversal sobre todos los casos con diagnóstico de EHNA registrado (K76 - CIE10) con análisis de adecuación diagnóstica según criterios estándar. RESULTADOS: Se analizaron 290 pacientes, 76 fueron diagnosticados de EHNA (26,1%), 44 mujeres (57,9%). El análisis multivariado ajustado por edad y sexo mostró asociación entre EHNA y sexo masculino (OR: 0,5; IC 95%: 0,3-0,9), diabetes mellitus (DM) (OR: 2,42; IC 95%: 1,2-4,9) e hipertensión arterial (HTA) (OR: 3,07; IC 95%: 1,6-5,6). De los 209 con registro diagnóstico de EHNA: 51 (24,4%) cumplían criterios de EHNA. El resto carecían de registros suficientes. Destacan: 53,1% carecían de hipertransaminasemia mantenida; 48% de serologías víricas; 11% de ecografía abdominal compatible y 53,1% de registro del consumo de alcohol. CONCLUSIONES: La EHNA severa es frecuente entre los pacientes con hipertransaminasemia mantenida. La DM y la HTA incrementan significativamente el riesgo de EHNA. El diagnóstico de EHNA se registra sin considerar todos los criterios de EHNA y se hace mayoritariamente por ecografía. Se deberían unificar criterios diagnósticos en el registro de la EHNA
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated transaminases in adults. AIM: Determine the prevalence of NASH in patients with sustained hypertransaminasemia, and Know the adequacy of the registered in Primary Care (AP) diagnosis. MATERIAL AND METHODS: 1) Cross-sectional study with a random sample of patients with elevated alanine aminotransferase (ALT) held (ALT> 32 for ≥6 months), ruling out other causes of liver disease, according to clinical, laboratory and ultrasound scan criteria in AP and 2) cross-sectional description of all cases diagnosed with NASH recorded (K76 - ICD10) with diagnostic adequacy analysis according to standard criteria. RESULTS: 290 patients were analyzed: 76 were diagnosed as NASH (26.1%), 44 women (57.9%). Multivariate analysis adjusted for age and sex showed no association between NASH and male gender (OR: 0.5; CI95%: 0.3-0.9), diabetes mellitus (DM) (OR: 2.42; CI95%: 1.2-4.9) and hypertension blood pressure (HBP) (OR: 3.07; CI 95% 1.6-5.6). Of the 209 diagnosed with NASH record: 51 (24.4%) met the criteria for NASH. The rest had insufficient records. Highlights: 53.1% lacked sustained hypertransaminasemia; 48% of viral serology; 11% supported and 53.1% abdominal ultrasound registration of alcohol. CONCLUSIONS: Severe NASH is frequent among patients with sustained hypertransaminasemia. The DM and hypertension significantly increase the risk of NASH. The diagnosis of NASH is recorded without considering all criteria and mainly NASH made by ultrasonography. They should unify diagnostic criteria in the register of NASH (AU)
Subject(s)
Adolescent , Young Adult , Adult , Middle Aged , Aged , Humans , Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/pathology , Non-alcoholic Fatty Liver Disease , Primary Health Care , Transaminases , Prevalence , Indicators of Morbidity and Mortality , Obesity/complications , Insulin Resistance/physiology , Metabolic Syndrome/complications , Metabolic Syndrome/pathology , Liver Diseases/complications , Liver Diseases/diagnosis , Fatty Liver/pathology , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies , Randomized Controlled Trials as Topic , SpainABSTRACT
UNLABELLED: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated transaminases in adults. AIM: Determine the prevalence of NASH in patients with sustained hypertransaminasemia, and Know the adequacy of the registered in Primary Care (AP) diagnosis. MATERIAL AND METHODS: 1) Cross-sectional study with a random sample of patients with elevated alanine aminotransferase (ALT) held (ALT> 32 for ≥6 months), ruling out other causes of liver disease, according to clinical, laboratory and ultrasound scan criteria in AP and 2) cross-sectional description of all cases diagnosed with NASH recorded (K76 - ICD10) with diagnostic adequacy analysis according to standard criteria. RESULTS: 290 patients were analyzed: 76 were diagnosed as NASH (26.1%), 44 women (57.9%). Multivariate analysis adjusted for age and sex showed no association between NASH and male gender (OR: 0.5; CI95%: 0.3-0.9), diabetes mellitus (DM) (OR: 2.42; CI95%: 1.2-4.9) and hypertension blood pressure (HBP) (OR: 3.07; CI 95% 1.6-5.6). Of the 209 diagnosed with NASH record: 51 (24.4%) met the criteria for NASH. The rest had insufficient records. HIGHLIGHTS: 53.1% lacked sustained hypertransaminasemia; 48% of viral serology; 11% supported and 53.1% abdominal ultrasound registration of alcohol. CONCLUSIONS: Severe NASH is frequent among patients with sustained hypertransaminasemia. The DM and hypertension significantly increase the risk of NASH. The diagnosis of NASH is recorded without considering all criteria and mainly NASH made by ultrasonography. They should unify diagnostic criteria in the register of NASH.
Subject(s)
Alanine Transaminase/blood , Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/epidemiology , Primary Health Care , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prevalence , Reproducibility of Results , Retrospective StudiesABSTRACT
BACKGROUND: Common interventions for smoking cessation are based on medical advice and pharmacological aid. Information and communication technologies may be helpful as interventions by themselves or as complementary tools to quit smoking. The objective of the study was to determine the use of information and communication technologies (ICTs) in the smoking population attended in primary care, and describe the major factors associated with its use. METHODS: Descriptive observational study in 84 health centres in Cataluña, Aragon and Salamanca. We included by simple random sampling 1725 primary healthcare smokers (any amount of tobacco) aged 18-85. Through personal interview professionals collected Socio-demographic data and variables related with tobacco consumption and ICTs use were collected through face to face interviews Factors associated with the use of ICTs were analyzed by logistic regression. RESULTS: Users of at least one ICT were predominantly male, young (18-45 years), from most favoured social classes and of higher education. Compared with non-ICTs users, users declared lower consumption of tobacco, younger onset age, and lower nicotine dependence. The percentages of use of email, text messages and web pages were 65.3%, 74.0% and 71.5%, respectively. Factors associated with the use of ICTs were age, social class, educational level and nicotine dependence level. The factor most closely associated with the use of all three ICTs was age; mainly individuals aged 18-24. CONCLUSIONS: The use of ICTs to quit smoking is promising, with the technology of mobile phones having a broader potential. Younger and more educated subjects are good targets for ICTs interventions on smoking cessation.
