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Association of Histopathological and Biochemical Aspects of NAFLD With the Severity of Liver Fibrosis in Individuals With Obesity: Cross-sectional Study

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Abstract

Background

Given the importance of fibrosis in the progression of non-alcoholic fatty liver disease (NAFLD), identifying biochemical and histopathological aspects associated with its severity is important to determine the course of disease in high-risk populations.

Objectives

The study aims to investigate correlations between biochemical and histopathological variables associated with the occurrence and severity of NAFLD-related liver fibrosis in individuals with obesity.

Methods

This is a cross-sectional study which enrolled 171 individuals who underwent bariatric surgery at a tertiary university hospital. Clinical, laboratory, and histopathological hepatic characteristics were analyzed. Univariate and multivariate analyses were carried out to identify factors associated with the outcomes studied (severity of fibrosis staging) through simple and multiple regression models.

Results

Female were 87.7%, and the mean age was 38.4 ± 9.3 years. The most common histopathological abnormalities were macrovesicular steatosis (74.9%) and hepatocellular ballooning (40.4%). In the histopathological univariate analysis, liver fibrosis significantly correlated with severities of microvesicular steatosis (p = 0.003), lobular inflammation (p = 0.001), and NAS (p < 0.001). In the multivariate analysis, the degrees of microvesicular steatosis (p < 0.001) and NAS (p < 0.001) independently correlated with fibrosis severity. In the univariate biochemical analysis, fibrosis severity significantly correlated with levels of hemoglobin A1c (p = 0.004) and glucose (p = 0.01). In the multivariate analysis, glucose levels independently correlated with liver fibrosis degree (p = 0.007).

Conclusion

Significant and independent associations were observed between the intensities of microvesicular steatosis, NAS, and glucose levels and the severity degree of liver fibrosis in individuals with obesity.

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Authors and Affiliations

  1. Dept. of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Alexander Fleming, S/No Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil

    Carollyne Rodovalho Guerra Carneiro, Arthur Balestra Silveira Ayres, Martinho Antonio Gestic, Murillo Pimentel Utrini, Felipe David Mendonça Chaim, Francisco Callejas-Neto, Elinton Adami Chaim & Everton Cazzo

Authors
  1. Carollyne Rodovalho Guerra Carneiro
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  2. Arthur Balestra Silveira Ayres
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  3. Martinho Antonio Gestic
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  4. Murillo Pimentel Utrini
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  5. Felipe David Mendonça Chaim
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  6. Francisco Callejas-Neto
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  7. Elinton Adami Chaim
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  8. Everton Cazzo
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Corresponding author

Correspondence to Everton Cazzo.

Ethics declarations

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Human and Animal Rights

The study was approved by the local committee of ethics in research under the reference number 5.921.274/FCM-UNICAMP and all participants signed an informed consent form. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare no competing interests.

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Key Points

1. The intensity of microvesicular steatosis independently correlated with liver fibrosis severity.

2. Non-alcoholic fatty liver disease Activity Score (NAS) independently correlated with liver fibrosis severity.

3. Glucose levels independently correlated with liver fibrosis severity.

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Carneiro, C.R.G., Ayres, A.B.S., Gestic, M.A. et al. Association of Histopathological and Biochemical Aspects of NAFLD With the Severity of Liver Fibrosis in Individuals With Obesity: Cross-sectional Study. OBES SURG 34, 1569–1574 (2024). https://doi.org/10.1007/s11695-024-07180-x

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