Predictive factors to estimate the severity of nonalcoholic fatty liver disease in candidates for Roux-en-Y gastric bypass.

Telma Souza E Silva Gebara, Ingrid Felicidade, Giselle Nobre Costa, Marilia Zaparolli de Ramos, Ana Carolina Bonde, Giovani Palermo, Samuel Guemra, José Henrique de Souza Peres, Mário Sérgio Mantovani, Rodrigo Picheth Di Napoli, Antônio Carlos Ligocki Campos

Journal: Nutrition (Burbank, Los Angeles County, Calif.) 2023;116():112190

PMID: 37734118

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVES

Non-alcoholic fatty liver disease (NAFLD) is related to obesity, insulin resistance, dyslipidemia, and metabolic syndrome. The increasing prevalence of NAFLD results in a significant number of patients manifesting chronic liver disease over time. The aim of this study was to analyze the predictive factors to estimate NAFLD severity in patients who are candidates for Roux-en-Y gastric bypass.

METHODS

This descriptive observational study was conducted with 136 obese patients who were candidates for Roux-en-Y gastric bypass and had mild, moderate, or severe NAFLD.

RESULTS

Severe NAFLD was more prevalent among the men (P = 0.007), and mild NAFLD was more prevalent among the women (P = 0.007). Hyperferritinemia was observed in the group with severe NAFLD (P = 0.01). Neck circumference and waist-to-height ratio were associated with an increased risk when comparing the groups with mild and severe NAFLD and those with moderate and severe NAFLD (P = 0.023 and P = 0.001, respectively); the alanine aminotransferase (ALT) and aspartate aminotransferase ratio values were >1 (P = 0.002) in the same comparisons. The regression analyses showed that an increase of 1 ng/mL in vitamin D reduced the chances of severe steatosis by 10% (P = 0.043), and an increase of 1 U/L ALT increased the chances of severe steatosis by 13% (P = 0.002).

CONCLUSION

High neck circumference and low waist-to-height ratio values, male sex, hyperferritinemia, increased serum ALT values, and decreased vitamin D levels were related to the risk for severe NAFLD.

Address: Department of Clinical Surgery, Federal University of Parana, Curitiba, Brazil. Electronic address: [email protected].; Department of Pathology, Clinical Analysis and Toxicology, State University of Londrina, Brazil.; Pitagoras Unopar Anhanguera University, Londrina, Brazil; Department of Food Science and Technology, State University of Londrina, Brazil.; Department of Clinical Surgery, Federal University of Parana, Curitiba, Brazil.; Positivo University, Curitiba, Brazil.; Pitagoras Unopar Anhanguera University, Londrina, Brazil.; Department of General Biology, State University of Londrina, Brazil.; Bioconsult, Curitiba, Brazil.

DOI: 10.1016/j.nut.2023.112190

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MeSH Terms: Humans, Male, Female, Non-alcoholic Fatty Liver Disease, Gastric Bypass, Hyperferritinemia, Obesity, Vitamin D, Alanine Transaminase