Non alcoholic steatohepatitis (EHNA) is diagnosed by hepatic biopsy. Its etiology is uncertain but obesity is present in 69100% of all cases and type 2 diabetes mellitus (DM) in about 3475%.
Objectives: To study the prevalence of EHNA in morbidly obese patients and determine if there is a difference between the prevalence in patients with and without carbohydrate metabolism disorders.
Patients and methods: Prospective study of 120 females and 32 males with morbid obesity (IMC: 51.1+8.9 kg/m2). The mean age was 42.4+9.3 years. Viral hepatitis was discarded by serological studies and toxic abuse with complete anamnesis. When the presence of DM was unknown an oral glucose tolerance test (OGTT) was done. During bariatric surgery hepatic biopsy was practised for pathological study; informed consent was obtained prior to the procedure. The data was analysed statistically by χ2 test.
Results: Forty-eight patients (31.5%) presented type 2 DM, 32.4% of the cases were diagnosed by OGTT. The results of the pathological study of the hepatic tissue are:
|Impaired glucose tolerance||0.7%||5.6%||6.2%||12.5%|
In diabetic patients steatosis was present with a frequency of 57.7% and EHNA of 31.1%. No significant differences were observed between the prevalence of EHNA and steatosis in patients with diabetes and those with normoglycemia.
Conclusions: Steatosis is the most frequent finding in diabetic morbidly obese patients followed by EHNA. The prevalence of EHNA in diabetic patients with morbid obesity is high. No differences were observed between the prevalence of EHNA in patients with DM and those withouth disorders of the carbohydrate metabolism. These results strongly suggest that obesity plays a more important role than DM in the etiology of the EHNA.
03 - 07 May 2008
European Society of Endocrinology