Obesity Surgery

, Volume 28, Issue 1, pp 187–194 | Cite as

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

  • Everton CazzoEmail author
  • Laísa Simakawa Jimenez
  • Martinho Antonio Gestic
  • Murillo Pimentel Utrini
  • Fábio Henrique Mendonça Chaim
  • Felipe David Mendonça Chaim
  • José Carlos Pareja
  • Elinton Adami Chaim
Original Contributions



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).


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).


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).


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.


Fatty liver Obesity Insulin resistance Bariatric surgery Biomarkers 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Informed Consent

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

Statement of Human and Animal Rights

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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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Everton Cazzo
    • 1
    Email author
  • Laísa Simakawa Jimenez
    • 1
  • Martinho Antonio Gestic
    • 1
  • Murillo Pimentel Utrini
    • 1
  • Fábio Henrique Mendonça Chaim
    • 1
  • Felipe David Mendonça Chaim
    • 1
  • José Carlos Pareja
    • 1
  • Elinton Adami Chaim
    • 1
  1. 1.Department of Surgery, Faculty of Medical SciencesState University of Campinas (UNICAMP)CampinasBrazil

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