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Doctoral Thesis
Full name
Cacilda Pedrosa de Oliveira
Knowledge Area
Date of Defense
São Paulo, 2006
Strauss, Edna (President)
Alves, Venancio Avancini Ferreira
Cotrim, Helma Pinchemel
Jacob Filho, Wilson
Lanzoni, Valeria Pereira
Title in Portuguese
"Alterações hepáticas em grandes obesos: avaliações clínico-laboratoriais e histopatológicas antes do tratamento cirúrgico da obesidade"
Keywords in Portuguese
Fígado gorduroso
Fígado/anatomia & histologia
Resistência à insulina
Síndrome X metabólica
Abstract in Portuguese
A doença hepática gordurosa não-alcoólica (DHGNA) e a esteatohepatite (EHNA) são freqüentes nos obesos. O objetivo foi determinar a prevalência de DHGNA/EHNA e Síndrome Metabólica (SM) nos grandes obesos; definir preditores de EHNA; estabelecer critérios histológicos para o diagnóstico da EHNA. Avaliados 325 pacientes encaminhados à cirurgia bariátrica (IMC = 35 kg/m2), dos quais 146 foram submetidos à análise histológica; as variáveis clínicas e bioquímicas analisadas e correlacionadas com a histologia. A DHGNA ocorreu em 111 (76%) pacientes e a prevalência de EHNA, conforme critério histológico usado, em 25,3% a 55,5%; SM ocorreu em 57,2%. Os preditores da EHNA foram: SM; alterações glicêmicas; hipertrigliceridemia e HAS. Foram preditores de fibrose: idade acima de 30 anos e AST elevada
Title in English
Hepatic alterations in severely obese patients: clinical-laboratory and histopatological evaluations before surgical treatment of obesity
Keywords in English
Fatty liver
Insulin resistance
Liver/anatomy & histology
Metabolic syndrome X
Abstract in English
Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) has been associated with obesity. Determine prevalence of NAFLD/NASH and metabolic syndrome (MS) in severe obesity; define clinical predictor of steatohepatitis; establish histological criteria necessary to diagnose NASH. Evaluation of 325 patients submitted to bariatric surgery (BMI = 35 kg/m2), among which 146 were submitted to histological analysis; variables clinical and biochemical were analyzed and correlated to histological characteristics. NAFLD occurred in 111 (76%) patients and NASH, according to histological criteria used, in 25.3% to 55.5%; MS was present in 57.2%. Predictors of NASH: MS; glycaemic alterations; hypertriglyceridaemia and high blood pressure (HBP). Predictors of fibrosis: age above 30 years and high AST
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