• Fábio Henrique Ribeiro Maldonado, Paulo Ferreira Mega, Carlos Wustemberg Germano, Luana Leite Castilho Dias, Guilherme Hoverter Callejas, Martinho Antonio Gestic, Murillo Pimentel Utrini, Felipe David Mendonça Chaim, Francisco Callejas-Neto, Elinton Adami Chaim, and Everton Cazzo.
• MD. Resident Physician, Department of Surgery, Campinas Medical Center (CMC), Campinas (SP), Brazil.
• Sao Paulo Med J. 2024 Jan 1; 142 (1): e2022663e2022663.

BackgroundThe effect of weight loss (WL) on histopathological aspects of non-alcoholic fatty liver disease (NAFLD) may provide further insights into the dynamics of hepatic recovery after WL.ObjectiveTo analyze the effects of pre-operative WL on insulin resistance- and NAFLD-related histology in individuals undergoing bariatric surgery (BS) with or without pre-operative WL.Design And SettingA matched cross-sectional study was conducted at a public university hospital and a private clinic in Campinas, Brazil.MethodsAn analytical, observational, cross-sectional study was conducted using prospectively collected databases of individuals who underwent BS and liver biopsy at either a public tertiary university hospital (with pre-operative WL) or a private clinic (without pre-operative WL). Random electronic matching by gender, age, and body mass index (BMI) was performed and two paired groups of 24 individuals each were selected.ResultsOf the 48 participants, 75% were female. The mean age was 37.4 ± 9.6. The mean BMI was 38.9 ± 2.6 kg/m2. Fibrosis was the most common histopathological abnormality (91.7%). Glucose was significantly lower in the WL group (92 ± 19.1 versus 111.8 ± 35.4 mg/dL; P = 0.02). Significantly lower frequencies of macrovesicular steatosis (58.3% versus 95.8%; P = 0.004), microvesicular steatosis (12.5% versus 87.5%; P < 0.001), and portal inflammation (50% versus 87.5%; P = 0.011) were observed in the WL group.ConclusionPre-operative WL was significantly associated with lower frequencies of macro- and mi- crovesicular steatosis, portal inflammation, and lower glycemia, indicating an association between the recent trajectory of body weight and histological aspects of NAFLD.

11 keywords...

hide…