Aspectos da sÃndrome metabÃlica na doenÃa hepÃtica gordurosa nÃo-alcoÃlica em pacientes obesos mÃrbidos

AUTOR(ES)

LÃcia Helena de Oliveira Cordeiro

DATA DE PUBLICAÇÃO

2003

RESUMO

Obesity has become an epidemic disease in whose prevalence in going up throughout the world, particularly in its malignant form, the severe obesity. The severe obesity represents the Insulin Resistance Syndrome and its high risks of morbi-mortality to it related like diabetes, cancers, miocardial infartation and liver damage: liver steatosis, non alcoholic stetohepatitis, liver cancers.The purpose of this study is to avaliate metabolic risk factors with the nonalcoholic fatty liver disease (NAFLD). We studied 35 severe obese patients submitted to a liver bipsy during the bariatric surgery. Anthropometry and blood chemistry: glucose, total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride and aminotransferases were done. Patientes with alcohol intake more than 80g per week, viral hepatitis or another known liver disease were excluded. The prevalence of NAFDL was 88.6%, 32,2% grade I, 45,2% grade II and 25,6% grade III this one is non alcoholic steatohepatitis (NASH). There were a predominance of female (68,6% vs. 31,4%) male. Mean age was 37 years, mean time of obesity was 18 years, mean Body mass Index was 53,04. Waist Hip Index (WHI) has shown association with advantaged grade of liver disease, although it was not statiscally significant. The metabolic feature that most associated with NAFDL was dislipidemia with hypercholeterolemia being the more prevalent. However, hipertriglycemia correlates better with severe grade of liver disease (p=0,084), instead this is not statiscally significantly. Diabetes had a prevalance of 8,6%, while hypertension occured in 60%. AST was abnormal in only 16,1% of patients with grade II and III. While ALT abnormallity occured in 41% of patientes grade II and III. In conclusion, the non-alcoholic fatty liver disease has high prevalence in severe obeses suggesting an association with WHI and hypertryglyceridemia

ASSUNTO(S)

cirurgia bariÃtrica obesidade mÃrbida obesidade grave doenÃa hepÃtica gordurosa nÃo alcoÃlica medicina

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