Feijó Suerda Guiomar, Lima José Milton de Castro, Oliveira Maria Aparecida Alves de, Patrocínio Régia Maria Vidal, Moura-Junior Luis Gonzaga, Campos Antônio Borges, Lima José Wellington Oliveira, Braga Lúcia Libanez Bessa Campelo
Acta Cir Bras. 2013 Nov;28(11):788-93. doi: 10.1590/s0102-86502013001100008.
To determine the prevalence of non alcoholic fatty liver disease (NAFLD) and non alcoholic steatohepatitis (NASH) in morbidly obese patients undergoing bariatric surgery and to identify risk factors associated with the disease spectrum.
Liver biopsy was performed in 60 patients who underwent bariatric surgery, after other causes of liver disease were excluded. Clinical, biochemical and histological features were evaluated.
NAFLD was detected in fifty-seven patients (95%) of the sample and forty patients (66.7%) of the total sample met the criteria for NASH. Perisinusoidal fibrosis was only found in three (7.5%) patients with NASH. The γGT was an independent predictive factor associated with the degree of hepatic steatosis. The variables such as dyslipidemia and ALT were independently associated with the presence of Mallory's corpuscles with the following values, respectively, OR 0, 05, 95% CI 0.002 to 0.75, P = 0.031 and OR 10, 99, 95% CI 1.44 to 83.93, P = 0.021.
Non alcoholic fatty liver disease seems to be an obese-related condition with approximately half of asymptomatic morbidly obese patients having histological NASH. The γGT was an independent predictor of the degree of steatosis.
确定接受减肥手术的病态肥胖患者中非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）的患病率，并识别与疾病谱相关的危险因素。
在60例接受减肥手术的患者中，排除其他肝病病因后进行肝活检。评估临床、生化和组织学特征。
样本中的57例患者（95%）检测出NAFLD，总样本中的40例患者（66.7%）符合NASH标准。仅在3例（7.5%）NASH患者中发现窦周纤维化。γ-谷氨酰转移酶（γGT）是与肝脂肪变性程度相关的独立预测因素。血脂异常和丙氨酸氨基转移酶（ALT）等变量分别与马洛里小体的存在独立相关，其值如下，比值比（OR）为0.05，95%置信区间（CI）为0.002至0.75，P = 0.031；OR为10.99，95%CI为1.44至83.93，P = 0.021。
非酒精性脂肪性肝病似乎是一种与肥胖相关的疾病，约一半无症状的病态肥胖患者存在组织学上的NASH。γGT是脂肪变性程度的独立预测指标。
