Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study

• Published in: São Paulo medical journal Vol. 134; no. 1; pp. 79 - 83
• Main Authors: Cazzo, Everton, Jimenez, Laísa Simakawa, Gallo, Fábio de Felice, Pareja, José Carlos, Chaim, Elinton Adami
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Associação Paulista de Medicina - APM 01.01.2016; Associação Paulista de Medicina
• Subjects: Adolescent; Adult; Bariatric surgery; Biopsy; Cross-Sectional Studies; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - pathology; Fatty liver; Fatty Liver - pathology; Female; Fibrosis; Gastric Bypass - adverse effects; Humans; Insulin resistance; Liver - pathology; Male; MEDICINE, GENERAL & INTERNAL; Middle Aged; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - etiology; Non-alcoholic Fatty Liver Disease - pathology; Obesity; Obesity, Morbid - surgery; Young Adult; Obesity; Fatty liver; Cirurgia bariátrica; Diabetes mellitus; Bariatric surgery; Insulin resistance; Obesidade; Fígado gorduroso; Resistência à insulina
• ISSN: 1516-3180; 1806-9460; 1806-9460
• DOI: 10.1590/1516-3180.2015.01652409

Nonalcoholic fatty liver disease (NAFLD) has become a public health concern. It encompasses a wide spectrum of histological abnormalities and has close relationships with insulin resistance and type 2 diabetes mellitus (T2DM). This study sought to compare the histological alterations observed in morbidly obese individuals with and without T2DM who underwent Roux-en-Y gastric bypass. Cross-sectional study in a tertiary-level public hospital. This was a cross-sectional study on 197 individuals who underwent gastric bypass surgery between 2011 and 2013. NAFLD was assessed through liver biopsies. T2DM was diagnosed through the International Diabetes Federation criteria. Non-diabetics presented significantly more biopsies without any histological abnormalities, regarding steatosis (42.6% versus 25.5%; P = 0.0400), fibrosis (60.6% versus 36.2%; P = 0.0042) and steatohepatitis (27.3% versus 12.8%; P = 0.0495), while diabetics presented significantly higher frequency of moderate forms of steatosis (36.2% versus 20%; P = 0.0307) and fibrosis (23.4% versus 4%; P = 0.0002). T2DM was associated with more advanced forms of NAFLD within the population studied. NAFLD has previously been correlated with severe forms of heart disease. Screening for and early detecting of NAFLD in high-risk populations are important for avoiding further development of severe forms and the need for liver transplantation.