The prevalence of nonalcoholic fatty liver disease in the Americas

Annals of Hepatology

Volumn 13, Issue 2, 2014, Pages 166-178

  López Velázquez, Jorge A ^a   Silva Vidal, Karen V ^a   Ponciano Rodríguez, Guadalupe ^b   Chávez Tapia, Norberto C ^a   Arrese, Marco ^c   Uribe, Misael ^a   Méndez Sánchez, Nahum ^a  

^a LIVER RESEARCH UNIT   (Mexico)

^b UNIVERSIDAD NACIONAL AUTÓNOMA DE MÉXICO   (Mexico)

^c PONTIFICIA UNIVERSIDAD CATÓLICA DE CHILE   (Chile)

Author keywords

Diabetes mellitus; Epidemiology; Metabolic syndrome; Obesity

Indexed keywords

BARBADOS; BELIZE; CHILE; CHRONIC LIVER DISEASE; CORRELATIONAL STUDY; COSTA RICA; DISEASE ASSOCIATION; DISEASE COURSE; DISEASE PREDISPOSITION; DISEASE SEVERITY; DYSLIPIDEMIA; ECUADOR; ENVIRONMENTAL FACTOR; ETHNICITY; GENETICS; GUYANA; HEREDITY; HUMAN; INSULIN RESISTANCE; LIFESTYLE; LIPID DIET; METABOLIC SYNDROME X; MEXICO; NON INSULIN DEPENDENT DIABETES MELLITUS; NONALCOHOLIC FATTY LIVER; OBESITY; OXIDATIVE STRESS; PARAGUAY; PHYSICAL ACTIVITY; PREVALENCE; PUERTO RICO; REVIEW; RISK FACTOR; UNITED STATES; URUGUAY; VENEZUELA;

CENTRAL AMERICA; DIABETES COMPLICATIONS; FATTY LIVER; HUMANS; NORTH AMERICA; OBESITY; PREVALENCE; SOUTH AMERICA;

EID: 84893696694     PISSN: 16652681     EISSN: None     Source Type: Journal    
DOI: 10.1016/s1665-2681(19)30879-8     Document Type: Review

References (123)

1. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, Charlton M, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol 2012; 55: 2005-23.
2. de Alwis NM, Day CP. Non-alcoholic fatty liver disease: the mist gradually clears. J Hepatol 2008; 48: 104-12.
3. Available from: http://www.paho.org/hq/index.php?option=com_content&view=article&id=3501&Itemid=2391 (Interactive visualization of leading causes of deaths, Region of the Americas 2009-2010, working age population 40-65 years).
4. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002; 346: 1221-31.
5. Méndez-Sánchez N, Arrese M, Zamora Valdés D, Uribe M. Current concepts in the pathogenesis of nonalcoholic fatty liver disease. Liver Int 2007; 27: 423-33.
6. Sanyal AJ, Banas C, Sargeant C, Luketic VA, Sterling RK, Stravitz RT, Shiffman ML, et al. Similarities and differences in outcomes of cirrhosis due to nonalcoholic steatohepatitis and hepatitis C. Hepatology 2006; 43: 682-9.
7. Ascha MS, Hanouneh IA, Lopez R, Tamimi TA, Feldstein AF, Zein NN. The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis. Hepatology 2010; 51: 1972-8.
8. Wieckowska A, Feldstein AE. Diagnosis of nonalcoholic fatty liver disease: invasive versus noninvasive. Semin Liver Dis 2008; 28: 386-95.
9. Obika M, Noguchi H. Diagnosis and evaluation of nonalcoholic fatty liver disease. Exp Diabetes Res 2012; 2012: 145-754.
10. Browning JD, Szczepaniak LS, Dobbins R, Nuremberg P, Horton JD, Cohen JC, Grundy SM, et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology 2004; 40: 1387-95.
11. Ryan CK, Johnson LA, Germin BI, Marcos A. One hundred consecutive hepatic biopsies in the workup of living donors for right lobe liver transplantation. Liver Transpl 2002; 8: 1114-22.
12. Roldan-Valadez E, Favila R, Martínez-López M, Uribe M, Ríos C, Méndez-Sánchez N. In vivo 3T spectroscopic quantification of liver fat content in nonalcoholic fatty liver disease: correlation with biochemical method and morphometry. J Hepatol 2010; 53: 732-7.
13. Fishbein M, Castro F, Cheruku S, Jain S, Webb B, Gleason T, Stevens WR. Hepatic MRI for fat quantitation: its relationship to fat morphology, diagnosis, and ultrasound. J Clin Gastroenterol 2005; 39: 619-25.
14. Feldstein AE, Wieckowska A, Lopez AR, Liu YC, Zein NN, McCullough AJ. Cytokeratin-18 fragment levels as noninvasive biomarkers for nonalcoholic steatohepatitis: a multicenter validation study. Hepatology 2009; 50: 1072-8.
15. Milner KL, van der Poorten D, Xu A, Bugianesi E, Kench JG, Lam KS, Chisholm DJ, et al. Adipocyte fatty acid binding protein levels relate to inflammation and fibrosis in nonalcoholic fatty liver disease. Hepatology 2009; 49: 1926-34.
16. Li H, Fang Q, Gao F, Fan J, Zhou J, Wang X, Zhang H, et al. Fibroblast growth factor 21 levels are increased in nonalcoholic fatty liver disease patients and are correlated with hepatic triglyceride. J Hepatol 2010; 53: 934-40.
17. Ruhl CE, Everhart JE. Determinants of the association of overweight with elevated serum alanine aminotransferase activity in the United States. Gastroenterology 2003; 124: 71-9.
18. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011; 34: 274-85.
19. Williams CD, Stengel J, Asike MI, Torres DM, Shaw J, Contreras M, Landt CL, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology 2011; 140: 124-31.
20. Bellentani S, Scaglioni F, Marino M, Bedogni G. Epidemiology of nonalcoholic fatty liver disease. Dig Dis 2010; 28: 155-61.
21. Aballay LR, Eynard AR, Díaz Mdel P, Navarro A, Muñoz SE. Overweight and obesity: a review of their relationship to metabolic syndrome, cardiovascular disease, and cancer in South America. Nutr Rev 2013; 71: 168-79.
22. Aballay LR, Osella AR, Celi A, Díaz M. Overweight and obesity: prevalence and their association with some social characteristics in a random sample populationbased study in Córdoba city, Argentina. Obes Res Clin Pract 2009; 3: 75-83.
23. World Health Organization. The Global Health Observatory 2012. Available at: http://www.who.int/gho/en/index.html
24. Cuevas A, Alvarez V, Olivos C. The emerging obesity problem in Latin America. Expert Rev Cardiovasc Ther 2009; 7: 281-8.
25. Rivera JA, Barquera S, González-Cossío T, Olaiz G, Sepúlveda J. Nutrition transition in Mexico and in other Latin American countries. Nutr Rev 2004; 62: 149-57.
26. Pan American Health Organization; Health in the Americas 2012. Available at: http://new.paho.org/saludenlasamericas.
27. Ratziu V, Bellentani S, Cortez-Pinto H, Day C, Marchesini G. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol 2010; 53: 372-84.
28. Das K, Das K, Mukherjee PS, Ghosh A, Ghosh S, Mridha AR, Dhibar T, et al. Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease. Hepatology 2010; 51: 1593-602.
29. Carrillo-Iregui A, Lopez-Mitnik G, Cossio S, Garibay-Nieto N, Arheart KL, Messiah SE. Relationship between aminotransferases levels and components of the metabolic syndrome among multiethnic adolescents. J Pediatr Endocrinol Metab 2010; 23: 1253-61.
30. Clark JM, Brancati FL, Diehl AM. The prevalence and etiology of elevated aminotransferase levels in the United States. Am J Gastroenterol 2003; 98: 960-7.
31. Skelly MM, James PD, Ryder SD. Findings on liver biopsy to investigate abnormal liver function tests in the absence of diagnostic serology. J Hepatol 2001; 35: 195-9.
32. Lynne E. Correlates and heritability of nonalcoholic fatty liver disease in a minority cohort. Obesity (Silver Spring) 2009; 7: 1240-6.
33. Cotrim HP, Parise E, Oliveira, Leite N, Martinelli A, Galizzi J, De Cassia R, et al. Nonalcoholic fatty liver disease in Brazil: clinical and histological profile. Ann Hepatol 2011; 10: 33-7.
34. Perez M, Gonzáles L, Olarte R, Rodríguez NI, Tabares M, Salazar JP, Jaimes S, et al. Nonalcoholic fatty liver disease is associated with insulin resistance in a young Hispanic population. Prev Med 2011; 52: 174-7.
35. Lizardi-Cervera J, Laparra DI, Chavez-Tapia NC, Ostos ME, Esquivel MU. Prevalence of NAFLD and metabolic syndrome in asymptomatic subjects. Rev Gastroenterol Mex 2006; 71: 453-9.
36. Riquelme A, Arrese M, Soza A, Morales A, Baudrand R, Pérez-Ayuso RM, González R, et al. Non-alcoholic fatty liver disease and its association with obesity, insulin resistance and increased serum levels of C-reactive protein in Hispanics. Liver Int 2009; 29: 82-8.
37. Lazo M, Hernaez R, Eberhardt MS, Bonekamp S, Kamel I, Guallar E, Koteish A, et al. Prevalence of nonalcoholic fatty liver disease in the United States: The Third National Health and Nutrition Examination Survey, 1988-1994. Am J Epidemiol 2013; 178: 38-45.
38. Minervini MI, Ruppert K, Fontes P, Volpes R, Vizzini G, de Vera ME, Gruttadauria S, et al. Liver biopsy findings from healthy potential living liver donors: reasons for disqualification, silent diseases and correlation with liver injury tests. J Hepatol 2009; 50: 501-10.
39. Karnikowski M, Córdova C, Oliveira RJ, Karnikowski MG, Nóbrega Ode T. Non-alcoholic fatty liver disease and metabolic syndrome in Brazilian middle-aged and older adults. Sao Paulo Med J 2007; 125: 333-7.
40. Matteoni L, Boente L, Soares D, Leal R, Campos F, César Araújo, D'Almeida F, et al. Nonalcoholic fatty hepatic disease: relevance of the diagnosis on abdominal ultrasound. Gazeta Médica da Bahia 2011; 81: 7-9.
41. Parise ER, Salgado AL, Secaf R, Cerri L, Cerri G. Prevalence of liver steatosis in abdominal ultrasound. GED 2003; 22: 235-7.
42. Rocha R, Cotrim HP, Bitencourt AG, Barbosa DB, Santos AS, Almeida Ade M, Cunha B, et al. Nonalcoholic fatty liver disease in asymptomatic Brazilian adolescents. World J Gastroenterol 2009; 15: 473-7.
43. Liangpunsakul S, Chalasani N. Unexplained elevations in alanine aminotransferase in individuals with the metabolic syndrome: results from the third National Health and Nutrition Survey (NHANES III). Am J Med Sci 2005; 329: 111-6.
44. Weston SR, Leyden W, Murphy R, Bass NM, Bell BP, Manos MM, Terrault NA. Racial and ethnic distribution of nonalcoholic fatty liver in persons with newly diagnosed chronic liver disease. Hepatology 2005; 41: 372-9.
45. Gambarin-Gelwan M, Kinkhabwala SV, Schiano TD, Bodian C, Yeh HC, Futterweit W. Prevalence of nonalcoholic fatty liver disease in women with polycystic ovary syndrome. Clin Gastroenterol Hepatol 2007; 5: 496-501.
46. Kunde SS, Lazenby AJ, Clements RH, Abrams GA. Spectrum of NAFLD and diagnostic implications of the proposed new normal range for serum ALT in obese women. Hepatology 2005; 42: 650-6.
47. Roesch-Dietlen F, Dorantes-Cuéllar A, Carrillo-Toledo MG, Martínez-Sibaja C, Rojas-Carrera S, Bonilla-Rojas QC, Uchino-Higueras V, et al. Frequency of NAFLD in a group of patients with metabolic syndrome in Veracruz, Mexico. Rev Gastroenterol Mex 2006; 71: 446-52.
48. Castro-Martínez MG, Banderas-Lares DZ, Ramírez-Martínez JC, Escobedo-de A, la Peña J. Prevalence of nonalcoholic fatty liver disease in subjects with metabolic syndrome. Cir Cir 2012; 80: 128-33.
49. Gutierrez-Grobe Y, Ponciano-Rodríguez G, Ramos MH, Uribe M, Méndez-Sánchez N. Prevalence of non alcoholic fatty liver disease in premenopausal, postmenopausal and polycystic ovary syndrome women. The role of estrogens. Ann Hepatol 2010; 9: 402-9.
50. de Oliveira CP, de Mello ES, Alves VA, Saviero SM, Strauss E. Changes in histological criteria lead to different prevalences of nonalcoholic steatohepatitis in severe obesity. Ann Hepatol 2007; 6(4): 255-61.
51. Lima ML, Mourao SC, Diniz MT, Leite VH. Hepatic histopathology of patients with morbid obesity submitted to gastric bypass. Obes Surg 2005; 15: 661-9.
52. Leite NC, Villela-Nogueira CA, Pannain VL, Bottino AC, Rezende GF, Cardoso CR, Salles GF. Histopathological stages of nonalcoholic fatty liver disease in type 2 diabetes: prevalences and correlated factors. Liver Int 2011; 3: 700-6.
53. Boza C, Riquelme A, Ibañez L, Duarte I, Norero E, Viviani P, Soza A, et al. Predictors of nonalcoholic steatohepatitis (NASH) in obese patients undergoing gastric bypass. Obes Surg 2005; 15: 1148-53.
54. Petersen KF, Dufour S, Feng J, Befroy D, Dziura J, Dalla Man C, Cobelli C, et al. Increased prevalence of insulin resistance and nonalcoholic fatty liver disease in Asian-Indian men. Proc Natl Acad Sci USA 2006; 103: 18273-77.
55. Caldwell SH, Harris DM, Patrie JT, Hespenheide EE. Is NASH underdiagnosed among African Americans? Am J Gastroenterol 2002; 97: 1496-500.
56. Bambha K, Belt P, Abraham M, Wilson LA, Pabst M, Ferrell L, Unalp-Arida A, et al. Ethnicity and nonalcoholic fatty liver disease. Hepatology 2012; 55: 769-80.
57. Daly AK, Ballestri S, Carulli L, Loria P, Day CP. Genetic determinants of susceptibility and severity in nonalcoholic fatty liver disease. Expert Rev Gastroenterol Hepatol 2011; 5: 253-63.
58. Sookoian S, Pirola CJ. Meta-analysis of the influence of I148M variant of patatin-like phospholipase domain containing 3 genes (PNPLA3) on the susceptibility and histological severity of nonalcoholic fatty liver disease. Hepatology 2011; 53: 1883-94.
59. Valenti L, Nobili V, Al-Serri A, Rametta R, Leathart JB, Zappa MA, et al. The APOC3 T-455C and C-482T promoter region polymorphisms are not associated with the severity of liver damage independently of PNPLA3 I148M genotype in patients with nonalcoholic fatty liver. J Hepatol 2011; 55(6): 1409-14.
60. Schwimmer JB, Celedon MA, Lavine JE, Salem R, Campbell N, Schork NJ, Shiehmorteza M, et al. Heritability of nonalcoholic fatty liver disease. Gastroenterology 2009; 136: 1585-92.
61. Struben VM, Hespenheide EE, Caldwell SH. Nonalcoholic steatohepatitis and cryptogenic cirrhosis within kindreds. Am J Med 2000; 108: 9-13.
62. Chalasani N, Guo X, Loomba R, Goodarzi MO, Haritunians T, Kwon S, et al. Genome-wide association study identifies variants associated with histologic features of nonalcoholic Fatty liver disease. Gastroenterology 2010; 139(5): 1567-76.
63. Otgonsuren M, Stepanova M, Gerber L, Younossi ZM. Anthropometric and clinical factors associated with mortality in subjects with nonalcoholic fatty liver disease. Dig Dis Sci 2013; 58: 1132-40.
64. Bellentani S, Saccoccio G, Masutti F, Crocè LS, Brandi G, Sasso F, Cristanini G, Tiribelli C. Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med 2000; 132: 112-7.
65. Targher G, Bertolini L, Padovani R, Rodella S, Tessari R, Zenari L, Day C, et al. Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients. Diabetes Care 2007; 30: 1212-8.
66. Machado M, Cortez-Pinto H. NASH, insulin resistance and iron. Liver Int 2006; 26: 1159-62.
67. Stranges S, Dorn JM, Muti P, Freudenheim JL, Farinaro E, Russell M, Nochajski TH, et al. Body fat distribution, relative weight, and liver enzyme levels: a population-based study. Hepatology 2004; 39: 754-63.
68. Samuel VT, Liu ZX, Qu X, Elder BD, Bilz S, Befroy D, Romanelli AJ, et al. Mechanism of hepatic insulin resistance in non-alcoholic fatty liver disease. J Biol Chem 2004; 279: 32345-53.
69. Green RM. NASH-hepatic metabolism and not simply the metabolic syndrome. Hepatology 2003; 38: 14-7.
70. Sanyal AJ, Campbell-Sargent C, Mirshahi F, Rizzo WB, Contos MJ, Sterling RK, Luketic VA. Nonalcoholic steatohepatitis: association of insulin resistance and mitochondrial abnormalities. Gastroenterology 2001; 120: 1183-92.
71. Beymer C, Kowdley KV, Larson A, Edmonson P, Dellinger EP, Flum DR. Prevalence and predictors of asymptomatic liver disease in patients undergoing gastric bypass surgery. Arch Surg 2003; 138: 1240-4.
72. Pinheiro AC, Rojas P, Carrasco F, Gómez P, Mayas N, Morales I. Acanthosis nigricans as an indicator of insulin resistance in Chilean adult population. Nutr Hosp 2011; 26: 940-4.
73. Musso G, Gambino R, Cassader M, Pagano G. Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of noninvasive tests for liver disease severity. Ann Med 2011; 43: 617-49.
74. th edn. Brussels, Belgium: International Diabetes Federation, 2011. Available at: http://www.idf.org/diabetesatlas
75. Chitturi S, Farrell GC. Etiopathogenesis of nonalcoholic steatohepatitis. Semin Liver Dis 2001; 21: 27-41.
76. Vanni E, Bugianesi E, Kotronen A, De Minicis S, Yki-Järvinen H, Svegliati-Baroni G. From the metabolic syndrome to NAFLD or vice versa? Dig Liver Dis 2010; 42: 320-30.
77. Yilmaz Y. NAFLD in the absence of metabolic syndrome: different epidemiology, pathogenetic mechanisms, risk factors for disease progression? Semin Liver Dis 2012; 32: 14-21.
78. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52.
79. Einhorn D, Reaven GM, Cobin RH, Ford E, Ganda OP, Handelsman Y, Hellman R, et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003; 9: 237-52.
80. Alberti KG, Zimmet P, Shaw J. IDF. The metabolic syndrome-a new worldwide definition. Lancet 2005; 366: 1059-62.
81. Tillin T, Forouhi N, Johnston DG, McKeigue PM, Chaturvedi N, Godsland IF. Metabolic syndrome and coronary heart disease in South Asians, African-Caribbeans and white Europeans: a UK population-based cross-sectional study. Diabetología 2005; 48: 649-56.
82. Aschner P, Buendía R, Brajkovich I, Gonzalez A, Figueredo R, Juarez XE, Uriza F, et al. Determination of the cutoff point for waist circumference that establishes the presence of abdominal obesity in Latin American men and women. Diabetes Res Clin Pract 2011; 93: 243-7.
83. Riediger N, Clara I. Prevalence of metabolic syndrome in the Canadian adult population. CMAJ 2011; 183: E1127-E1134.
84. Ford ES. Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the US. Diabetes Care 2005; 28: 2745-9.
85. Hunt KJ, Resendez RG, Williams K, Haffner SM, Stern MP. National Cholesterol Education Program versus Would Health Organization in relation to all cause and cardiovascular mortality in the San Antonio Heart Study. Circulation 2004; 110: 1251-7.
86. Rojas R, Aguilar-Salinas CA, Jiménez-Corona A, Shamah-Levy T, Rauda J, Avila-Burgos L, Villalpando S, et al. Metabolic syndrome in Mexican adults. Results from the National Health and Nutrition Survey 2006. Salud Pub Mex 2010; 52: 11-8.
87. Aguilar-Salinas CA, Rojas R, Gómez-Pérez FJ, Valles V, Ríos-Torres JM, Franco A, Olaiz G, et al. High prevalence of metabolic syndrome in Mexico. Arch Med Res 2004; 35: 76-81.
88. Williams ES, Baylin A, Campos H. Adipose tissue arachidonic acid and the metabolic syndrome in Costa Rican adults. Clin Nutr 2007; 26: 474-82.
89. Araujo Y, Roque C, Escobar E, Abraham E. Caracterización del síndrome metabólico en pacientes de la provincial de Santiago de Cuba, año 2010. Rev Latinoamer Patol Clin 2013; 60: 96-10.
90. Juarez X, Benitez J, Quezada R, Cerritos R, Aguilar R. Prevalencia del síndrome metabólico en la población urbana de San Salvador. Asociación latinoamericana de diabetes 2006; 19: 25-30. Available at: http://revistaalad.com.ar/pdfs/060103.pdf
91. Gregory CO, Dai J, Ramirez-Zea M, Stein AD. Occupation is more important than rural or urban residence in explaining the prevalence of metabolic and cardiovascular disease risk in Guatemalan adults. J Nutr 2007; 137: 1314-9.
92. Hall J, Alvarenga M, Gómez O. Prevalence of hypertension in adults in El Progreso, Yoro, Honduras. Rev Med Hondur 2005; 73: 60-64. Available at: http://www.bvs.hn/RMH/pdf/2005/pdf/Vol73-2-2005-2.pdf
93. DeBoer MD, Chen D, Burt DR, Ramirez-Zea M, Guerrant RL, Stein AD, Martorell R, et al. Early childhood diarrhea and cardiometabolic risk factors in adulthood: the Institute of Nutrition of Central America and Panama Nutritional Supplementation Longitudinal Study. Ann Epidemiol 2013; 23: 314-20.
94. Pérez CM, Guzmán M, Ortiz AP, Estrella M, Valle Y, Pérez N, Haddock L, et al. Prevalence of the metabolic syndrome in San Juan, Puerto Rico. Ethn Dis 2008; 18: 434-41.
95. Gomez M, Ramirez M, Disdier O. Prevalence of the metabolic syndrome among a determined Puerto Rican population. P R Health Sci J 2006; 25: 111-6.
96. Marquezine GF, Oliveira CM, Pereira AC, Krieger JE, Mill JG. Metabolic syndrome determinants in an urban population from Brazil: social class and gender-specific interaction. Int J Cardiol 2008; 129: 259-65.
97. Salaroli LB, Barbosa GC, Mill JG, Molina MC. Prevalence of metabolic syndrome in population-based study, Vitoria, ES-Brazil. Arq Bras Endocrinol Metabol 2007; 51: 1143-52.
98. Velásquez-Meléndez G, Gazzinelli A, Côrrea-Oliveira R, Pimenta AM, Kac G. Prevalence of metabolic syndrome in a rural area of Brazil. Sao Paulo Med J 2007; 125: 155-62.
99. de Oliveira EP, de Souza ML, de Lima MD. Prevalence of metabolic syndrome in a semi-arid rural area in Bahia. Arq Bras Endocrinol Metabol 2006; 50: 456-65.
100. Mujica V, Leiva E, Icaza G, Diaz N, Arredondo M, Moore-Carrasco R, Orrego R, et al. Evaluation of metabolic syndrome in adults of Talca city, Chile. Nutr J 2008; 7: 14.
101. Pinzón JB, Serrano NC, Díaz LA, Mantilla G, Velasco HM, Martínez LX, Millán PA, et al. Impact of the new definitions in the prevalence of the metabolic syndrome in an adult population at Bucaramanga, Colombia. Biomedica 2007; 27: 172-9.
102. Medina-Lezama J, Zea-Diaz H, Morey-Vargas OL, Bolaños-Salazar JF, Muñoz-Atahualpa E, Postigo-MacDowall M, Corrales-Medina F. Prevalence of the metabolic syndrome in Peruvian Andean Hispanics: the PREVENCION study. Diabetes Res Clin Pract 2007; 78: 270-81.
103. Schettini C, Schwedt E, Moreira V, Mogdasy C, Chávez L, Bianchi M, et al. Prevalencia del síndrome metabolic en una población adulta. Rev Urug Cardiol 2004; 19: 19-28. Available at: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S0797-00482004000100003&lng=es
104. Florez H, Silva E, Fernández V, Ryder E, Sulbarán T, Campos G, Calmón G, et al. Prevalence and risk factors associated with the metabolic syndrome and dyslipidemia in white, black, Amerindian and mixed Hispanics in Zulia State, Venezuela. Diabetes Res Clin Pract 2005; 69: 63-77.
105. Ferguson T, Tulloch-Reid M, Younger N, Knight-Madden J, Samms-Vaughan M, Ashley D, Broeck J, et al. Prevalence of the metabolic syndrome and its components in relation to socioeconomic status among Jamaican young adults: a cross-sectional study. BMC Public Health 2010; 10: 307.
106. Escobedo J, Schargrodsky H, Champagne B, Silva H, Boissonnet CP, Vinueza R, Torres M, et al. Prevalence of the metabolic syndrome in Latin America and its association with subclinical carotid atherosclerosis: the CARMELA cross-sectional study. Cardiovasc Diabetol 2009; 8: 52.
107. World Health Organization. World health statistics 2013. Available at: http://apps.who.int/iris/bitstream/10665/81965/1/9789241564588_eng.pdf
108. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 2012; 307: 491-7.
109. Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet 2011; 378: 815-25.
110. Gotay CC, Katzmarzyk PT, Janssen I, Dawson MY, Aminoltejari K, Bartley NL. Updating the Canadian obesity maps: an epidemic in progress. Can J Public Health 2012; 104: 64-8.
111. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among adults: United States, 2011-2012. NCHS Data Brief 2013; 131: 1-8.
112. ENSANUT 2012. Available at: http://ensanut.insp.mx/informes/ENSANUT2012ResultadosNacionales.pdf
113. Health in the Americas 2012. Available at: http://www.paho.org/saludenlasamericas/index.php?option=com_content&view=article&id=9&Itemid=14&lang=en
114. Brathwaite N, Brathwaite A, Taylor M. The socio-economic determinants of obesity in adults in the Bahamas. West Indian Med J 2011; 60: 434-41.
115. World Health Organization, NCD Country Profiles 2011. Available at: http://www.who.int/nmh/publications/ncd_profiles_report.pdf
116. Panamerican Health Organization. Encuesta de Diabetes, hipertensión y factores de riesgo de enfermedades crónicas, San José, Costa Rica 2009. Available at: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=16262&Itemid=
117. Morejóng A, Rodríuez M, Díez E, García D, Salas V, Ordúñez P. Metabolic syndrome in a health area of Cienfuegos. CARMEN Second Measurement. Finlay 2011; 1: 6-14.
118. Estudio Factores de Riesgo Cardiovascular y Síndrome Metabólico (Efricard II). Available at: http://saludfunglode.org/documentos/efricard-2.pdf
119. Cardone A, Borracci R, Milin E. Estimación a largo plazo de la prevalencia de obesidad en la Argentina. Rev Argent Cardiol 2010; 78: 23-9.
120. Navía O, Caballero D, Flores J, Gutiérrez V, Ramírez W. Prevalencia de factores de riesgo asociado a diabetes mellitus tipo 2 en población mayor de 20 años en los servicios de salud de II y III nivel del área urbana y rural en Bolivia. 2007. Cuad Hosp Clin 2007; 52: 53-58. Available at: http://www.revistasbolivianas.org.bo/scielo.php?script=sci_arttext&pid=S1652-67762007000200008&lng=es
121. Ministerio de Salud Chile. Resultados de la Encuesta nacional de enfermedades. 2009-2010. MINSAL 2010. Available at: http://epi.minsal.cl/wp-content/uploads/2012/07/InformeENS_2009-2010_CAP1.pdf
122. Encuesta Nacional de la Situación Nutricional en Colombia 2010 (ENSIN). Available at: http://www.icbf.gov.co/portal/page/portal/Descargas1/Resumenfi.pdf
123. Ministerio de Salud Pública y Bienestar Social (MSP y BS). Organización Panamericana de la Salud (OPS-OMS). Agencia Española de Cooperación Internacional y Desarrollo (AECID). Primera Encuesta Nacional de Factores de Riesgo No Transmisibles. Paraguay, 2011. Available at: http://www.who.int/chp/steps/2011_STEPS_Paraguay_leaflet.pdf