Article
Nonalcoholic fatty liver disease in severely obese individuals: The influence of bariatric surgery
Registro en:
ANDRADE, A. R. et al. Nonalcoholic fatty liver disease in severely obese individuals: The influence of bariatric surgery. Annals of Hepatology, v. 7, n. 4, p. 364-368, 2008.
0939-5555
Autor
Andrade, Antônio Ricardo de
Cotrim, Helma Pinchemel
Alves, Erivaldo
Soares, Daniela
Rocha, Raquel
Almeida, Alessandro de Moura
Almeida, Carolina de Godoy
Freitas, Luiz Antonio Rodrigues de
Resumen
FAPESB (Fundação de Amparo a Pesquisa do Estado da Bahia), PRONEX - CNPq associated with NAFLD, and bariatric surgery (BAS) is
traditionally indicated for the treatment of severely
obese individuals. Here, we discuss the behavior and
prognosis of this liver disease following post-surgical
weight loss. Aim: To evaluate the influence of the BAS
on the clinical and biochemical parameters of NAFLD
in severely obese patients. Methodology: An intervention
study included obese individuals (BMI≥ 35kg/m2),
who had been submitted to liver biopsy during BAS
and had NAFLD. HAIR (hypertension, ALT and insulin
resistance and BAAT (BMI, ALT, age and triglycerides)
scores and FLI (Fatty Liver Index) were used to
compare the patients at the time of surgery, and 12-30
months following weight loss. Results: From October
2004 to September 2007, 122 patients were diagnosed
with NAFLD, 40 of whom agreed to participate in the
study. The mean age was 37.7 ± 12.5 years, 60% were
women and 80% had steatohepatitis (NASH) with fibrosis
upon analysis of the liver biopsy performed during
BAS. Mean weight loss was 46.0 ± 2.0 kg. After 21 ± 5.8
months of follow-up, a significant improvement was
found in all the variables analyzed (79.3% according
to the HAIR scores, 95.2% as measured by the BAAT
score and 72.5% by the FLI. Conclusion: The results
suggest that treatment of obesity by bariatric surgery
may influence the prognosis of NAFLD. In addition to
weight loss, we observed improvement in the clinical
and biochemical parameters related to NAFLD, such
as anthropometrics index, hypertension, aminotransferases,
triglycerides and insulin resistance.