Barros Fernando de, Setúbal Sergio, Martinho José Manoel, Ferraz Loraine, Gaudêncio Andressa
Andarai Federal Hospital, Department of Bariatric and Metabolic Surgery, Rio de Janeiro.
FIOCRUZ, Clinical Research, Rio de Janeiro.
Arq Bras Cir Dig. 2016 Nov-Dec;29(4):260-263. doi: 10.1590/0102-6720201600040011.
Obesity is an epidemic and chronic disease that can bring other comorbidities to the patient. Non-alcoholic fatty liver disease is present in up to 90% of these patients and can progress to hepatitis and hepatocarcinoma. The relationship of this liver disease and obesity is already well known; however, it is possible that some parameters of the comorbidities are more related than others in the pathophysiology of the disease.
Was analyzed the relationship between non-alcoholic fatty liver disease (NAFLD) and the comorbidities of metabolic syndrome in morbidly obese patients.
Was involved ultrasonography and laboratory assessment of obese patients before bariatric surgery. NAFLD was assessed using the same sonography parameters for all patients. Based on the results, the patients were divided into groups with and without NAFLD. Comparisons between them involved clinical and laboratory variables such as fasting blood glucose, insulin, HOMA-IR (homeostasis model assessment - insulin resistance), glycated hemoglobin, total cholesterol and fractions, triglycerides, alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, C-reactive protein, albumin and ferritin. Patients who reported alcohol abuse (defined as the consumption of >14 drinks per week) or who had hepatitis were excluded.
Eighty-two patients (74 women and 8 men) were studied, of whom 53 (64.6%) had NAFLD and 29 (35.4%) did not. The levels of glycated hemoglobin (p=0.05) and LDL cholesterol (p=0.01) were significantly altered in patients with NAFLD. However, weight, body mass index and excess weight did not differ significantly between the groups (p=0.835, p=0.488 and p=0.727, respectively).
Altered LDL cholesterol and glycated hemoglobin levels were related to the presence of NAFLD.
肥胖是一种流行病和慢性病，会给患者带来其他合并症。高达90%的此类患者存在非酒精性脂肪性肝病，且该病可进展为肝炎和肝癌。这种肝病与肥胖之间的关系已为人熟知；然而，在该疾病的病理生理学中，合并症的某些参数可能比其他参数关联更为密切。
分析病态肥胖患者中非酒精性脂肪性肝病（NAFLD）与代谢综合征合并症之间的关系。
纳入肥胖患者在接受减肥手术前的超声检查和实验室评估。所有患者均使用相同的超声参数评估NAFLD。根据结果，将患者分为有NAFLD组和无NAFLD组。两组之间的比较涉及临床和实验室变量，如空腹血糖、胰岛素、HOMA-IR（稳态模型评估-胰岛素抵抗）、糖化血红蛋白、总胆固醇及其组分、甘油三酯、丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶、C反应蛋白、白蛋白和铁蛋白。报告有酒精滥用（定义为每周饮酒超过14杯）或患有肝炎的患者被排除。
研究了82例患者（74例女性和8例男性），其中53例（64.6%）患有NAFLD，29例（35.4%）未患NAFLD。NAFLD患者的糖化血红蛋白水平（p=0.05）和低密度脂蛋白胆固醇水平（p=0.01）有显著改变。然而，两组之间的体重、体重指数和超重情况无显著差异（分别为p=0.835、p=0.488和p=0.727）。
低密度脂蛋白胆固醇和糖化血红蛋白水平的改变与NAFLD的存在有关。
