Mottin Cláudio Corá, Moretto Myriam, Padoin Alexandre Vontobel, Kupski Carlos, Swarowsky Aline Maria, Glock Luiz, Duval Vinicius, da Silva Jefferson Braga
Centro da Obesidade Mórbida, Hospital São Lucas PUCRS, Porto Alegre, Brazil.
Obes Surg. 2005 Jun-Jul;15(6):788-93. doi: 10.1381/0960892054222830.
Hepatic steatosis has a high prevalence among morbidly obese patients. Its relation to steatohepatitis and cirrhosis has been extensively studied among these patients. The aim of this study was to evaluate the behavior of hepatic steatosis with weight loss 1 year after bariatric surgery.
This study is a historical cohort that compared liver biopsies obtained from morbidly obese patients during the bariatric operation, with percutaneous biopsies taken from the same patient 1 year after surgery. The results were compared with weight loss, patients' profile (gender, age, body mass index (BMI) and waist/hip ratio), and with the presence of co-morbidities such as diabetes, hypertension, and dyslipidemia.
90 patients who had liver biopsies taken at the operation and postoperative period for bariatric surgery were included. The prevalence of hepatic steatosis was 87.6%. The average percent of excess weight loss was 81.4%. On the second biopsy, 16 patients (17.8%) of the total had the same degree of steatosis, 25 (27.8%) improved their steatosis pattern and 49 (54.4%) had normal hepatic tissue. There was no statistical difference regarding age, BMI, waist/hip ratio, and co-morbidities (P>0.05), but there was a difference in gender (P=0.044).
Significant improvement in the hepatic histology of steatosis was observed after weight loss induced by bariatric surgery in most patients. There was no patient with a worsening in the histology.
肝脂肪变性在病态肥胖患者中具有较高的患病率。在这些患者中,其与脂肪性肝炎和肝硬化的关系已得到广泛研究。本研究的目的是评估减肥手术后1年肝脂肪变性随体重减轻的变化情况。
本研究为历史性队列研究,比较了病态肥胖患者在减肥手术期间获取的肝脏活检标本与术后1年同一患者经皮活检的标本。将结果与体重减轻情况、患者特征(性别、年龄、体重指数(BMI)和腰臀比)以及合并症(如糖尿病、高血压和血脂异常)的存在情况进行比较。
纳入了90例在减肥手术的手术期和术后进行肝脏活检的患者。肝脂肪变性的患病率为87.6%。平均超重减轻百分比为81.4%。在第二次活检时,总体中有16例患者(17.8%)的脂肪变性程度相同,25例(27.8%)的脂肪变性模式有所改善,49例(54.4%)的肝组织正常。在年龄、BMI、腰臀比和合并症方面无统计学差异(P>0.05),但在性别方面存在差异(P=0.044)。
减肥手术诱导体重减轻后,大多数患者的肝脂肪变性组织学有显著改善。没有患者的组织学情况恶化。