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

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Abstract

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.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n, Campinas, São Paulo, 13083-887, Brazil

    Everton Cazzo, Laísa Simakawa Jimenez, Martinho Antonio Gestic, Murillo Pimentel Utrini, Fábio Henrique Mendonça Chaim, Felipe David Mendonça Chaim, José Carlos Pareja & Elinton Adami Chaim

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  1. Everton Cazzo
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  2. Laísa Simakawa Jimenez
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  4. Murillo Pimentel Utrini
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  5. Fábio Henrique Mendonça Chaim
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  6. Felipe David Mendonça Chaim
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Correspondence to Everton Cazzo.

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

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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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Cazzo, E., Jimenez, L.S., Gestic, M.A. et al. Type 2 Diabetes Mellitus and Simple Glucose Metabolism Parameters may Reliably Predict Nonalcoholic Fatty Liver Disease Features. OBES SURG 28, 187–194 (2018). https://doi.org/10.1007/s11695-017-2829-9

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  • DOI: https://doi.org/10.1007/s11695-017-2829-9

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