ABSTRACT
Objective:
To investigate
nonalcoholic fatty liver disease (
NAFLD),
nonalcoholic steatohepatitis (NASH) and hepatic
fibrosis in
biopsies of people with
obesity who underwent
bariatric surgery and examine the possible
association of different variables with a
diagnosis of
NAFLD and NASH. Materials and
methods:
Epidemiological, clinical and
laboratory data from 574 individuals with
obesity of both genders seen by the same
physician between 2003 and 2009
who had a
liver biopsy during
bariatric surgery were examined.
Results:
Of the 437
patients included, 39.8% had some degree of
liver fibrosis, 95% had a histologic
diagnosis of
NAFLD, and the
risk factors were age ≥ 28 years and Homeostatic Model Assessment (HOMA) ≥ 2.5 (p = 0.001 and p = 0.016, respectively). In the
NAFLD group, NASH was present in 26% of
patients and the associated factors were
aspartate aminotransferase and
alanine aminotransferase index (AST/ALT) > 1,
high-density lipoprotein cholesterol (HDL-c) < 40 mg/dL, total
cholesterol (TC) ≥ 200 mg/dL, gamma-glutamyl
transferase (GGT) > 38 U/L and
triglycerides (TG) levels > 150 mg/dL. The independent
risk factors were low HDL-c, elevated AST/ALT and high TG.
Conclusion:
The variables associated with a
diagnosis of
NAFLD were HOMA ≥ 2.5 and age ≥ 28 years. NASH was associated with low HDL-c, high TG and AST/ALT ≤ 1.