Type 2 Diabetes Mellitus and Simple Glucose Metabolism Parameters may Reliably Predict Nonalcoholic Fatty Liver Disease Features

• Published in: Obesity surgery Vol. 28; no. 1; pp. 187 - 194
• Main Authors: Cazzo, Everton, Jimenez, Laísa Simakawa, Gestic, Martinho Antonio, Utrini, Murillo Pimentel, Chaim, Fábio Henrique Mendonça, Chaim, Felipe David Mendonça, Pareja, José Carlos, Chaim, Elinton Adami
• Format: Journal Article
• Language: English
• Published: New York Springer US 2018; Springer Nature B.V
• Subjects: Adult; Bariatric Surgery; Biomarkers - metabolism; Blood Glucose - metabolism; Cross-Sectional Studies; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - surgery; Female; Glucose; Glycated Hemoglobin A - metabolism; Humans; Insulin resistance; Insulin Resistance - physiology; Liver diseases; Male; Medicine; Medicine & Public Health; Metabolism; Middle Aged; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Obesity; Obesity, Morbid - blood; Obesity, Morbid - complications; Obesity, Morbid - epidemiology; Obesity, Morbid - surgery; Original Contributions; Predictive Value of Tests; Prevalence; Reproducibility of Results; Surgery; Triglycerides - blood; Biomarkers; Obesity; Insulin resistance; Fatty liver; Bariatric surgery
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-017-2829-9

Objective This study aims to investigate the correlation between features of NAFLD among individuals with morbid obesity and the surrogate IR markers homeostasis model assessment (HOMA), product of triglycerides and glucose (TyG), and triglyceride-to-high-density-lipoprotein ratio (TG/HDL-c). Methods A cross-sectional study, which enrolled 89 individuals who consecutively underwent bariatric surgery from February through December 2015, was conducted. NAFLD was assessed through histological examination of liver biopsies and correlated with the values of HOMA, TyG, and TG/HDL-c and their respective cutoff points for insulin resistance (IR). Results xThe prevalence of liver steatosis was 68.5%; the affected individuals presented significantly higher fasting glucose levels ( p  < 0.01) and hemoglobin A1c ( p  < 0.01), and a significantly higher prevalence of type 2 diabetes mellitus (T2DM) ( p  < 0.001). Fibrosis occurred in 66.3% of the individuals and was significantly associated with higher levels of HbA1c ( p  < 0.05) and a higher prevalence of T2DM ( p  < 0.05). Steatohepatitis was present in 64% of the individuals and was significantly associated with older age ( p  < 0.05), higher levels of fasting glucose ( p  < 0.05), and a higher prevalence of T2DM ( p  < 0.001). After Bonferroni’s adjustment, T2DM was significantly correlated with fibrosis ( p  < 0.01) and steatohepatitis ( p  < 0.001) and older age was significantly correlated with fibrosis ( p  < 0.05). T2DM was the only variable independently associated with fibrosis and steatohepatitis ( p  < 0.05 in both cases). Conclusion T2DM was a significant predictor of NAFLD features among individuals undergoing bariatric surgery; higher Hb A1c was correlated with fibrosis. T2DM was independently associated with fibrosis and steatohepatitis. HOMA, TyG, and TG/HDL-c ratio did not present significant associations with NAFLD.