ABSTRACT
SUMMARY Introduction: NAFLD is an heterogeneous condition that includes steatosis and non-alcoholic steatohepatitis (NASH), in the absence of significant alcohol consumption, reaching 30% of the population. The most common risk factors are: age, gender, ethnicity, diabetes mellitus (DM), obesity, predisposition, metabolic syndrome (MS), insulin resistance (IR), drugs, and polycystic ovary syndrome. Objective: To describe the profile of patients with NAFLD seen at Hospital de Base of Rio Preto, in the state of São Paulo. Method: Patients with NAFLD were assessed, with medical and epidemiological data collected after informed consent. Results: Of the 62 patients evaluated, 76% were women, 73% Caucasians, and 71% were aged between 50 and 69 years and had no symptoms. Ultrasonography results showed steatosis in 84%. NASH was diagnosed in 61% of the sample. 21 patients underwent liver biopsy, of which 36% had cirrhosis, 1 had liver cancer, and 1 pure steatosis (5% each). Risk factors were found in 70% of patients with metabolic syndrome, 87% with increased waist circumference, 63% with dyslipidemia, 61% (n=38) with high blood pressure (HBP), 28% with DM, 52% physically inactive, and 44% with insulin resistance (IR) (HOMA> 3.5). There was an association between IR and NASH (p=0.013), IR and obesity (p=0.027), IR and MS (p=0.006), and MS and steatosis on medical ultrasound (USG) (p=0.014). Conclusion: The most frequent risk factors were MS and its variables: increased waist circumference, dyslipidemia and HBP. This underscores the importance of metabolic control in NAFLD and confirms its role as the hepatic component of metabolic syndrome.
RESUMO Introdução: a doença hepática gordurosa não alcoólica (DHGNA) é uma condição heterogênea que inclui esteatose e esteato-hepatite não alcoólica (NASH), na ausência de consumo significante de álcool, podendo atingir 30% da população. Fatores de risco mais comuns são idade, gênero, etnia, diabetes mellitus (DM), obesidade, predisposição, síndrome matabólica (SM), resistência à insulina (RI), drogas e síndrome do ovário policístico. Objetivo: descrever o perfil de portadores de DHGNA assistidos no Hospital de Base de São José do Rio Preto, SP. Método: foram avaliados pacientes com DHGNA e coletados dados clínico-epidemiológicos, após consentimento informado. Resultados: dos 62 pacientes estudados, houve predomínio de mulheres (76%), caucasoides (73%), idade entre a quinta e sexta décadas e assintomáticos (71%). Exame de ultrassonografia (US) mostrou esteatose em 84%. NASH foi diagnosticada em 61% da casuística. Em 21 pacientes, biópsia hepática mostrou cirrose em 36% e câncer de fígado e esteatose pura em um paciente (5%) cada. Dos fatores de risco, 70% dos pacientes apresentavam SM; 87%, cintura abdominal alterada; 63%, dislipidemia; 61% (n=38), hipertensão arterial sistêmica (HAS); 28%, DM; 52%, sedentarismo, e em 44% encontrou-se RI (HOMA>3,5). Houve associação entre RI e NASH (p=0,013), RI e obesidade (p=0,027), RI e SM (p=0,006), SM e esteatose à US (p=0,014). Conclusão: os fatores de risco mais frequentes foram SM e suas variáveis (cintura abdominal aumentada, dislipidemia e HAS), o que ressalta a importância do controle metabólico na DHGNA e corrobora o seu papel como componente hepático da SM.
Subject(s)
Humans , Male , Female , Adult , Non-alcoholic Fatty Liver Disease/etiology , Non-alcoholic Fatty Liver Disease/epidemiology , Reference Values , Biopsy , Brazil/epidemiology , Insulin Resistance , Tomography, X-Ray Computed , Prevalence , Risk Factors , Ultrasonography , Statistics, Nonparametric , Metabolic Syndrome/complications , Diabetes Complications , Waist Circumference , Non-alcoholic Fatty Liver Disease/pathology , Liver Cirrhosis/etiology , Liver Cirrhosis/pathology , Middle Aged , Obesity/complicationsABSTRACT
Introduction Nasal obstruction is one of the main rhinologic complaints, and two diseases must be investigated as differential diagnosis: rhinosinusal polyposis and inverted papilloma. Using traditionalmethods, the differential diagnosis between these diseases may be difficult. The morphometric study may be a useful tool for differential diagnosis and to define prognosis. Objective Calculate the morphometric values of rhinosinusal polyposis and inverted papilloma and compare the average of variables obtained between the groups. Methods The nasal mucus of 10 patients who had surgery in the Department of Otorhinolaryngology and Surgery of Head and Neck was studied; 5 had rhinosinusal polyposis and 5 had inverted papilloma. After the capture and print of corresponding data of each slide, the largest and smallest diameters of the nuclei were measured and the morphometric variables were calculated: average diameter, perimeter, ratio between largest and smallest diameter, volume, area, ratio of volume to area, form coefficient, contour index, and eccentricity. Results We found a significant difference (p < 0.05) between the two groups in the following morphometric variables: largest diameter, smallest diameter, average diameter, volume, area, perimeter, and ratio of volume to area, indicating that these parameters can be useful in diagnostic differentiation between these diseases. Conclusion We founded morphometric variables higher in patients with inverted papilloma, which can be related to the neoplastic origin of the inverted papilloma. The analysis of nuclear parameters is an instrument of great value in the differential diagnosis between rhinosinusal polyposis and inverted papilloma.