Histological behavior of hepatic steatosis in morbidly obese patients after weight loss induced by bariatric surgery.

BACKGROUND: Hepatic steatosis has a high prevalence among morbidly obese patients. Its relation to steatohepatitis and cirrhosis has been extensively studied among these patients. The aim of this study was to evaluate the behavior of hepatic steatosis with weight loss 1 year after bariatric surgery. METHODS: This study is a historical cohort that compared liver biopsies obtained from morbidly obese patients during the bariatric operation, with percutaneous biopsies taken from the same patient 1 year after surgery. The results were compared with weight loss, patients' profile (gender, age, body mass index (BMI) and waist/hip ratio), and with the presence of co-morbidities such as diabetes, hypertension, and dyslipidemia. RESULTS: 90 patients who had liver biopsies taken at the operation and postoperative period for bariatric surgery were included. The prevalence of hepatic steatosis was 87.6%. The average percent of excess weight loss was 81.4%. On the second biopsy, 16 patients (17.8%) of the total had the same degree of steatosis, 25 (27.8%) improved their steatosis pattern and 49 (54.4%) had normal hepatic tissue. There was no statistical difference regarding age, BMI, waist/hip ratio, and co-morbidities (P>0.05), but there was a difference in gender (P=0.044). CONCLUSION: Significant improvement in the hepatic histology of steatosis was observed after weight loss induced by bariatric surgery in most patients. There was no patient with a worsening in the histology.

Síndrome metabólica / Metabolic syndrome

Parece que a dislipidemia, hipertensão, obesidade, intolerância à glicose e a hiperinsulinemia fazem parte de uma única síndrome. É importante que os clínicos saibam como diagnosticar e tratar todos os componentes como um processo interrelacionado. A Síndrome Metabólica se desenvolve a partir da resistencia à insulina, aumentando o risco de doença aterosclerótica e de diabetes tipo 2, sendo a hiperinsulinemia a característica primária...