title: Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study.
abstract: OBJECTIVE
  Nonalcoholic fatty liver disease (NAFLD) has become a public health concern. It encompasses a wide spectrum of histological abnormalities and has close relationships with insulin resistance and type 2 diabetes mellitus (T2DM). This study sought to compare the histological alterations observed in morbidly obese individuals with and without T2DM who underwent Roux-en-Y gastric bypass.
  
  
  METHODS
  Cross-sectional study in a tertiary-level public hospital.
  
  
  METHODS
  This was a cross-sectional study on 197 individuals who underwent gastric bypass surgery between 2011 and 2013. NAFLD was assessed through liver biopsies. T2DM was diagnosed through the International Diabetes Federation criteria.
  
  
  RESULTS
  Non-diabetics presented significantly more biopsies without any histological abnormalities, regarding steatosis (42.6% versus 25.5%; P = 0.0400), fibrosis (60.6% versus 36.2%; P = 0.0042) and steatohepatitis (27.3% versus 12.8%; P = 0.0495), while diabetics presented significantly higher frequency of moderate forms of steatosis (36.2% versus 20%; P = 0.0307) and fibrosis (23.4% versus 4%; P = 0.0002).
  
  
  CONCLUSIONS
  T2DM was associated with more advanced forms of NAFLD within the population studied. NAFLD has previously been correlated with severe forms of heart disease.
  
  
  CONCLUSIONS
  Screening for and early detecting of NAFLD in high-risk populations are important for avoiding further development of severe forms and the need for liver transplantation.
authors.affiliation: Department of Surgery, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Everton
authors.initials: E
authors.lastname: Cazzo
authors.affiliation: Department of Surgery, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Laísa Simakawa
authors.initials: LS
authors.lastname: Jimenez
authors.affiliation: Department of Surgery, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Fábio de Felice
authors.initials: Fde F
authors.lastname: Gallo
authors.affiliation: Department of Surgery, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Pareja
authors.affiliation: Department of Surgery, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Elinton Adami
authors.initials: EA
authors.lastname: Chaim
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000473:pathology*; D005234:Fatty Liver / Q000473:pathology; D005260:Female; D005355:Fibrosis; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000209:etiology / Q000473:pathology*; D009767:Obesity, Morbid / Q000601:surgery*; D055815:Young Adult