Impact of Diabetes Mellitus and Insulin on Nonalcoholic Fatty Liver Disease in the Morbidly Obese
Introduction and aim. The prevalence of obesity, type 2 diabetes mellitus and non-alcoholic fatty liver disease are increasing. Type 2 diabetes mellitus may aggravate non-alcoholic fatty liver disease, increasing the risk of developing cirrhosis and hepatocellular carcinoma. This study aims to deter...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-07-01
|
| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119304818 |
| _version_ | 1819014240126631936 |
|---|---|
| author | Claudia B.M. Strey Luiz A. de Carli Sérgio R. Pioner Marciane Fantinelli Sabrina S. Gobbato Guilherme F. Bassols Alexandre Losekann Gabriela P. Coral |
| author_facet | Claudia B.M. Strey Luiz A. de Carli Sérgio R. Pioner Marciane Fantinelli Sabrina S. Gobbato Guilherme F. Bassols Alexandre Losekann Gabriela P. Coral |
| author_sort | Claudia B.M. Strey |
| collection | DOAJ |
| description | Introduction and aim. The prevalence of obesity, type 2 diabetes mellitus and non-alcoholic fatty liver disease are increasing. Type 2 diabetes mellitus may aggravate non-alcoholic fatty liver disease, increasing the risk of developing cirrhosis and hepatocellular carcinoma. This study aims to determine the effect of type 2 diabetes mellitus and insulin therapy on non-alcoholic fatty liver disease in the patients with morbid obesity. Material and methods. Clinical, anthropometric and laboratory data were analyzed together with intraoperative liver biopsies from morbidly obese patients undergoing bariatric surgery. Results. 219 patients with morbid obesity were evaluated. Systemic arterial hypertension (55.9% vs. 33.8%, p = 0.004) and dyslipidemia (67.1% vs. 39.0%, p < 0.001) were more prevalent in patients with diabetes when compared to patients without diabetes. In multivariate analysis, type 2 diabetes mellitus was an independent risk factor for severe steatosis (RR = 2.04, p = 0.023) and severe fibrosis (RR = 4.57, p = 0.013). Insulin therapy was significantly associated with non-alcoholic steatohepatitis (RR = 1.89, p = 0.001) and fibrosis (RR = 1.75, p = 0.050) when all patients were analysed, but when only patients with diabetes were analysed, insulin therapy was not associated with non-alcoholic steatohepatitis or fibrosis. Conclusion. Type 2 diabetes mellitus plays an important role in the progression of non-alcoholic fatty liver disease as an independent risk factor for severe fibrosis. |
| first_indexed | 2024-12-21T02:12:41Z |
| format | Article |
| id | doaj.art-1a50004206f2445f896b1fc6b6d72b30 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-21T02:12:41Z |
| publishDate | 2018-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-1a50004206f2445f896b1fc6b6d72b302022-12-21T19:19:19ZengElsevierAnnals of Hepatology1665-26812018-07-01174585591Impact of Diabetes Mellitus and Insulin on Nonalcoholic Fatty Liver Disease in the Morbidly ObeseClaudia B.M. Strey0Luiz A. de Carli1Sérgio R. Pioner2Marciane Fantinelli3Sabrina S. Gobbato4Guilherme F. Bassols5Alexandre Losekann6Gabriela P. Coral7Department of Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Correspondence and reprint request:Obesity Treatment Center, Santa Casa de Misericordia de Porto Alegre, Porto Alegre, RS, BrazilObesity Treatment Center, Santa Casa de Misericordia de Porto Alegre, Porto Alegre, RS, BrazilObesity Treatment Center, Santa Casa de Misericordia de Porto Alegre, Porto Alegre, RS, BrazilObesity Treatment Center, Santa Casa de Misericordia de Porto Alegre, Porto Alegre, RS, BrazilObesity Treatment Center, Santa Casa de Misericordia de Porto Alegre, Porto Alegre, RS, BrazilDepartment of Internal Medicine, Faculdade de Medicina da Pontifícia Universidade Católica do Rio Grande do Sul, Proto Alegre, RS, BrazilDepartment of Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, BrazilIntroduction and aim. The prevalence of obesity, type 2 diabetes mellitus and non-alcoholic fatty liver disease are increasing. Type 2 diabetes mellitus may aggravate non-alcoholic fatty liver disease, increasing the risk of developing cirrhosis and hepatocellular carcinoma. This study aims to determine the effect of type 2 diabetes mellitus and insulin therapy on non-alcoholic fatty liver disease in the patients with morbid obesity. Material and methods. Clinical, anthropometric and laboratory data were analyzed together with intraoperative liver biopsies from morbidly obese patients undergoing bariatric surgery. Results. 219 patients with morbid obesity were evaluated. Systemic arterial hypertension (55.9% vs. 33.8%, p = 0.004) and dyslipidemia (67.1% vs. 39.0%, p < 0.001) were more prevalent in patients with diabetes when compared to patients without diabetes. In multivariate analysis, type 2 diabetes mellitus was an independent risk factor for severe steatosis (RR = 2.04, p = 0.023) and severe fibrosis (RR = 4.57, p = 0.013). Insulin therapy was significantly associated with non-alcoholic steatohepatitis (RR = 1.89, p = 0.001) and fibrosis (RR = 1.75, p = 0.050) when all patients were analysed, but when only patients with diabetes were analysed, insulin therapy was not associated with non-alcoholic steatohepatitis or fibrosis. Conclusion. Type 2 diabetes mellitus plays an important role in the progression of non-alcoholic fatty liver disease as an independent risk factor for severe fibrosis.http://www.sciencedirect.com/science/article/pii/S1665268119304818NASHBariatric surgeryObese patientsSteatosis |
| spellingShingle | Claudia B.M. Strey Luiz A. de Carli Sérgio R. Pioner Marciane Fantinelli Sabrina S. Gobbato Guilherme F. Bassols Alexandre Losekann Gabriela P. Coral Impact of Diabetes Mellitus and Insulin on Nonalcoholic Fatty Liver Disease in the Morbidly Obese Annals of Hepatology NASH Bariatric surgery Obese patients Steatosis |
| title | Impact of Diabetes Mellitus and Insulin on Nonalcoholic Fatty Liver Disease in the Morbidly Obese |
| title_full | Impact of Diabetes Mellitus and Insulin on Nonalcoholic Fatty Liver Disease in the Morbidly Obese |
| title_fullStr | Impact of Diabetes Mellitus and Insulin on Nonalcoholic Fatty Liver Disease in the Morbidly Obese |
| title_full_unstemmed | Impact of Diabetes Mellitus and Insulin on Nonalcoholic Fatty Liver Disease in the Morbidly Obese |
| title_short | Impact of Diabetes Mellitus and Insulin on Nonalcoholic Fatty Liver Disease in the Morbidly Obese |
| title_sort | impact of diabetes mellitus and insulin on nonalcoholic fatty liver disease in the morbidly obese |
| topic | NASH Bariatric surgery Obese patients Steatosis |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119304818 |
| work_keys_str_mv | AT claudiabmstrey impactofdiabetesmellitusandinsulinonnonalcoholicfattyliverdiseaseinthemorbidlyobese AT luizadecarli impactofdiabetesmellitusandinsulinonnonalcoholicfattyliverdiseaseinthemorbidlyobese AT sergiorpioner impactofdiabetesmellitusandinsulinonnonalcoholicfattyliverdiseaseinthemorbidlyobese AT marcianefantinelli impactofdiabetesmellitusandinsulinonnonalcoholicfattyliverdiseaseinthemorbidlyobese AT sabrinasgobbato impactofdiabetesmellitusandinsulinonnonalcoholicfattyliverdiseaseinthemorbidlyobese AT guilhermefbassols impactofdiabetesmellitusandinsulinonnonalcoholicfattyliverdiseaseinthemorbidlyobese AT alexandrelosekann impactofdiabetesmellitusandinsulinonnonalcoholicfattyliverdiseaseinthemorbidlyobese AT gabrielapcoral impactofdiabetesmellitusandinsulinonnonalcoholicfattyliverdiseaseinthemorbidlyobese |