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维生素A营养状况与Roux-en-Y胃旁路手术治疗Ⅲ级肥胖后肝脂肪变性消退的关系。

Relationship of the nutritional status of vitamin A and the regression of hepatic steatosis after Roux-en-Y gastric bypass surgery for treatment of class III obesity.

作者信息

Oliveira e Silva Luiz Gustavo de, Manso José Eduardo Ferreira, Silva Rejane Andréa Ramalho Nunes da, Pereira Silvia Elaine, Saboya Sobrinho Carlos José, Rangel Cesar Wakoff

机构信息

Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, RJ, Brazil.

出版信息

Arq Bras Cir Dig. 2012 Oct-Dec;25(4):250-6.

Abstract

BACKGROUND

Vitamin A participates in several essentials functions in the human body and their serum concentrations may be decreased in non-transmissible diseases.

AIM

To assess the relationship of the nutritional status of Vitamin A through the serum concentrations of retinol and beta carotene, with regression of hepatic steatosis in individuals who undergone Roux-en-Y gastric bypass surgery for treatment of class III obesity.

METHODS

Were included 30 individuals, male and female, submitted to Roux-en-Y gastric bypass for treatment of class III obesity, who were diagnosed through an abdominal ultrasonography as presenting hepatic steatosis. From the result of an ultrasonography screened six months after the surgical procedure those subjects were divided into two groups: group 1 - patients with steatosis detected in the ultrasonography (16 subjects) and group 2 - patients without steatosis detected in the ultrasonography (14 subjects). Before and six months after the surgery, were carried out anthropometrical analyses and biochemical exams (basal insulin, glicemy, Homeostasis Model Assessment Index (HOMA IR), cholesterol, HDL, LDL, triglycerides, AST, ALT, Gamma-GT, albumin, total bilirubin, retinol, and beta carotene.

RESULTS

The individuals presented an average weight loss of 35.05 + 10.47 (p<0.01) and a decrease in the Body Mass Index (BMI) of 11.6 + 4.99 Kg/m² (p<0.01). After six months, all the biochemical exams presented a significant decrease in their basal concentrations (p<0.05). In the post-operative period the group 2 (without steatosis) presented concentrations significantly lower (p<0.05) in the following variables: weight, BMI, AST, ALT, Gamma-GT, HOMA IR, basal insulin. The albumin serum concentrations presented close average values, with no significant difference in the two periods evaluated. In the assessment of retinol and beta carotene, higher serum concentrations and a small decrease in relation to the concentrations of the pre-operative period in the group without steatosis were observed, however, no statistical difference was found.

CONCLUSION

An adequate nutritional status of vitamin A might contribute in the improvement of the hepatic esteatosis after Roux-en-Y gastric bypass for class III obesity treatment.

摘要

背景

维生素A参与人体多项重要功能,在非传染性疾病中其血清浓度可能降低。

目的

通过视黄醇和β-胡萝卜素的血清浓度评估维生素A的营养状况与接受Roux-en-Y胃旁路手术治疗Ⅲ级肥胖患者肝脂肪变性消退之间的关系。

方法

纳入30例接受Roux-en-Y胃旁路手术治疗Ⅲ级肥胖的患者,男女不限,通过腹部超声诊断为肝脂肪变性。根据手术后6个月的超声检查结果,将这些受试者分为两组:第1组-超声检查发现有脂肪变性的患者(16例)和第2组-超声检查未发现脂肪变性的患者(14例)。在手术前和手术后6个月,进行人体测量分析和生化检查(基础胰岛素、血糖、稳态模型评估指数(HOMA-IR)、胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三酯、谷草转氨酶、谷丙转氨酶、γ-谷氨酰转移酶、白蛋白、总胆红素、视黄醇和β-胡萝卜素)。

结果

患者平均体重减轻35.05±10.47(p<0.01),体重指数(BMI)降低11.6±4.99 Kg/m²(p<0.01)。6个月后,所有生化检查的基础浓度均显著降低(p<0.05)。在术后阶段,第2组(无脂肪变性)在以下变量中的浓度显著较低(p<0.05):体重、BMI、谷草转氨酶、谷丙转氨酶、γ-谷氨酰转移酶、HOMA-IR、基础胰岛素。白蛋白血清浓度呈现相近的平均值,在两个评估时期无显著差异。在对视黄醇和β-胡萝卜素的评估中,未发现脂肪变性的组中血清浓度较高,且与术前浓度相比略有下降,但未发现统计学差异。

结论

充足的维生素A营养状况可能有助于改善Roux-en-Y胃旁路手术后Ⅲ级肥胖患者的肝脂肪变性。

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