title: The Correlation Between Obesity-Related Diseases and Non-alcoholic Fatty Liver Disease in Women in the Pre-operative Evaluation for Bariatric Surgery Assessed by Transient Hepatic Elastography.
abstract: Non-alcoholic fatty liver disease (NAFLD) is a common, severe disease in obese patients. However, NAFLD is usually underestimated by ultrasonography. Liver biopsy is not routinely done in bariatric surgery or during the follow-up. This study therefore examined the correlation between metabolic syndrome and NAFLD in morbidly obese patients based on an assessment using transient hepatic elastography (THE).
  
  
  
  This study involved 50 female patients in the pre-operative phase for bariatric surgery. Before surgery, we collected clinical, laboratory, and anthropometric variables. THE measurements were obtained using a FibroScan® device (Echosens, Paris, France), and steatosis was quantified using Controlled Attenuation Parameter software (CAP). Statistical analyses were done using linear correlation and the Kruskal-Wallis test.
  
  
  
  The mean of THE and CAP values were 7.56 ± 4.78 kPa and 279.94 ± 45.69 dB/m, respectively, and there was a significant linear correlation between the two measurements (r = 0.651; p < 0.001). The numbers of metabolic syndrome parameters did not influence the THE (p = 0.436) or CAP (p = 0.422) values. HbA1c and HOMA-IR showed a strong linear correlation with CAP (r = 0.643, p = 0.013 and r = 0.668, p = 0.009, respectively) and a tendency to some linear correlation with THE (r = 0.500, p = 0.05 and r = 0.500, p = 0.002, respectively).
  
  
  
  Morbidly obese women submitted to FibroScan® presented a high prevalence of severe steatosis and advanced fibrosis in our sample. Insulin resistance parameters were correlated with steatosis, but less with fibrosis.
authors.affiliation: FIOCRUZ / Andarai Federal Hospital, Rio de Janeiro, RJ, Brazil. barroscirurgia@gmail.com.|Postgraduate Program, Fluminense Federal University, Niterói, RJ, Brazil. barroscirurgia@gmail.com.|, 118 João Lira St, Apt 102, Leblon, Rio de Janeiro, 22430-210, RJ, Brazil. barroscirurgia@gmail.com.
authors.forename: Fernando
authors.initials: F
authors.lastname: de Barros
authors.affiliation: Postgraduate Program in Medical Sciences, Fluminense Federal University, Niterói, RJ, Brazil.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Setúbal
authors.affiliation: Department of General Surgery, Fluminense Federal University, Niterói, RJ, Brazil.
authors.forename: José Manoel
authors.initials: JM
authors.lastname: Martinho
authors.affiliation: Internal Medicine Division, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil.
authors.forename: Nathalie Carvalho
authors.initials: NC
authors.lastname: Leite
authors.affiliation: Department of Gastroenterology, Fluminense Federal University, Niteroi, RJ, Brazil.
authors.forename: Thais
authors.initials: T
authors.lastname: Guaraná
authors.affiliation: Department of Statistics, Fluminense Federal University, Niterói, RJ, Brazil.
authors.forename: Ana Beatriz Soares
authors.initials: ABS
authors.lastname: Monteiro
authors.affiliation: School of Medicine, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil.
authors.forename: Cristiane A
authors.initials: CA
authors.lastname: Villela-Nogueira
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D054459:Elasticity Imaging Techniques; D005260:Female; D005602:France; D006801:Humans; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011300:Preoperative Care; D015995:Prevalence; D012720:Severity of Illness Index; D016387:Women's Health
keywords: Bariatric surgery; Fatty liver; Metabolic syndrome X; Morbid obesity; Non-invasive test; Transient elastography