title: Non-alcoholic fatty liver disease and its relationship with the nutritional status of vitamin A in individuals with class III obesity.
abstract: BACKGROUND
  The objective of the present study was to investigate vitamin A nutritional status in individuals with class III obesity through a biochemical indicator (retinol and beta-carotene serum levels), correlating these findings with non-alcoholic fatty liver disease (NAFLD) presence and its risk factors.
  
  
  METHODS
  The studied population was composed of 145 patients with morbid obesity [body mass index, BMI > or = 40 kg/m(2)) of both sexes. Retinol and beta-carotene serum levels were assessed by high performance liquid chromatography. The cutoff values used for serum retinol and beta-carotene inadequacy were <1.05 micromol/l and < or =40 microg/dl, respectively. Insulin resistance (IR) was assessed through homeostasis model assessment index (HOMA) method. Biochemical parameters of liver enzymes, lipid profile, and glycemia were analyzed. Anthropometric measurements were conducted. NAFLD diagnosis was performed through magnetic resonance.
  
  
  RESULTS
  NAFLD prevalence in the group was 71%. An inadequacy of 11.3 and 41.7% of retinol and beta-carotene serum levels, respectively, was found when NAFLD was present. A significant correlation of serum retinol with albumin liver and total bilirubin was found. As regards beta-carotene, a positive correlation for HDL-c variable and a negative correlation for the HOMA-IR, weight, and BMI variables were observed. There was a significant association between IR presence and retinol and beta-carotene inadequacy.
  
  
  CONCLUSIONS
  The high inadequacy of retinol and beta-carotene nutritional status in the sample, with a higher inadequacy in those with NAFLD, suggests an increase in the utilization of vitamin A in this group related to the fight against the oxidative stress to what they are exposed to. The significant association between retinol and beta-carotene with IR supports the hypothesis that vitamin A may have a protector effect on IR pathogenesis.
authors.affiliation: Micronutrients Research Group, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. gabrielavc@gmail.com
authors.forename: Gabriela
authors.initials: G
authors.lastname: Villaça Chaves
authors.forename: Silvia Elaine
authors.initials: SE
authors.lastname: Pereira
authors.forename: Carlos José
authors.initials: CJ
authors.lastname: Saboya
authors.forename: Andréa
authors.initials: A
authors.lastname: Ramalho
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications*; D012307:Risk Factors; D014801:Vitamin A / Q000097:blood*; D019207:beta Carotene / Q000097:blood*
chemical_list: D019207:beta Carotene; D014801:Vitamin A