Fernando de Barros1,2,3, Sérgio Setúbal4, José Manoel Martinho5, Nathalie Carvalho Leite6, Thais Guaraná7, Ana Beatriz Soares Monteiro8, Cristiane A Villela-Nogueira9. 1. FIOCRUZ / Andarai Federal Hospital, Rio de Janeiro, RJ, Brazil. barroscirurgia@gmail.com. 2. Postgraduate Program, Fluminense Federal University, Niterói, RJ, Brazil. barroscirurgia@gmail.com. 3. , 118 João Lira St, Apt 102, Leblon, Rio de Janeiro, 22430-210, RJ, Brazil. barroscirurgia@gmail.com. 4. Postgraduate Program in Medical Sciences, Fluminense Federal University, Niterói, RJ, Brazil. 5. Department of General Surgery, Fluminense Federal University, Niterói, RJ, Brazil. 6. Internal Medicine Division, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil. 7. Department of Gastroenterology, Fluminense Federal University, Niteroi, RJ, Brazil. 8. Department of Statistics, Fluminense Federal University, Niterói, RJ, Brazil. 9. School of Medicine, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil.
Abstract
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a common, severe disease in obese patients. However, NAFLD is usually underestimated by ultrasonography. Liver biopsy is not routinely done in bariatric surgery or during the follow-up. This study therefore examined the correlation between metabolic syndrome and NAFLD in morbidly obese patients based on an assessment using transient hepatic elastography (THE). MATERIAL AND METHODS: This study involved 50 female patients in the pre-operative phase for bariatric surgery. Before surgery, we collected clinical, laboratory, and anthropometric variables. THE measurements were obtained using a FibroScan® device (Echosens, Paris, France), and steatosis was quantified using Controlled Attenuation Parameter software (CAP). Statistical analyses were done using linear correlation and the Kruskal-Wallis test. RESULTS: The mean of THE and CAP values were 7.56 ± 4.78 kPa and 279.94 ± 45.69 dB/m, respectively, and there was a significant linear correlation between the two measurements (r = 0.651; p < 0.001). The numbers of metabolic syndrome parameters did not influence the THE (p = 0.436) or CAP (p = 0.422) values. HbA1c and HOMA-IR showed a strong linear correlation with CAP (r = 0.643, p = 0.013 and r = 0.668, p = 0.009, respectively) and a tendency to some linear correlation with THE (r = 0.500, p = 0.05 and r = 0.500, p = 0.002, respectively). CONCLUSION: Morbidly obese women submitted to FibroScan® presented a high prevalence of severe steatosis and advanced fibrosis in our sample. Insulin resistance parameters were correlated with steatosis, but less with fibrosis.
BACKGROUND:Non-alcoholic fatty liver disease (NAFLD) is a common, severe disease in obesepatients. However, NAFLD is usually underestimated by ultrasonography. Liver biopsy is not routinely done in bariatric surgery or during the follow-up. This study therefore examined the correlation between metabolic syndrome and NAFLD in morbidly obesepatients based on an assessment using transient hepatic elastography (THE). MATERIAL AND METHODS: This study involved 50 female patients in the pre-operative phase for bariatric surgery. Before surgery, we collected clinical, laboratory, and anthropometric variables. THE measurements were obtained using a FibroScan® device (Echosens, Paris, France), and steatosis was quantified using Controlled Attenuation Parameter software (CAP). Statistical analyses were done using linear correlation and the Kruskal-Wallis test. RESULTS: The mean of THE and CAP values were 7.56 ± 4.78 kPa and 279.94 ± 45.69 dB/m, respectively, and there was a significant linear correlation between the two measurements (r = 0.651; p < 0.001). The numbers of metabolic syndrome parameters did not influence the THE (p = 0.436) or CAP (p = 0.422) values. HbA1c and HOMA-IR showed a strong linear correlation with CAP (r = 0.643, p = 0.013 and r = 0.668, p = 0.009, respectively) and a tendency to some linear correlation with THE (r = 0.500, p = 0.05 and r = 0.500, p = 0.002, respectively). CONCLUSION: Morbidly obesewomen submitted to FibroScan® presented a high prevalence of severe steatosis and advanced fibrosis in our sample. Insulin resistance parameters were correlated with steatosis, but less with fibrosis.
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