Propriedades das variáveis antropométricas e laboratoriais como indicativas de doença hepática gordurosa não-alcoólica grave em indivíduos com obesidade grau II e III

Abstract

Introduction : Obesity is a pandemic disease. Obesity grade II and III often needs invasive treatment such as bariatric surgery. In these patients, comorbidities are frequent, including the nonalcoholic fatty liver disease (NAFLD), characterized by fatty infiltration of the liver of nonalcoholic etiology in individuals without other chronic liver diseases. Objectives : This study aimed to evaluate the properties of a group of anthropometric and laboratory tests according to the diagnosis of severe liver damage. Patients and Methods : We studied 845 patients with body mass index of 35 or more, with data from liver biopsy. We evaluated the properties (sensitivity, specificity, PPV, NPV, LR + and LR-) of anthropometric and laboratory, compared to the biopsy, for diagnosis of severe liver damage. The variable was dichotomized NAFLD in severe liver damage or not. Results : The prevalence of severe liver damage was 38.1% (95% CI 34.8 to 41.4). The average age of the individuals was 37.2 years and mean weight was 131.0 kg and prevalence of NAFLD was 53.3% higher in men (95% CI 47.0 to 59.7) than in women 32.1% (95% CI 28.3 to 36.9). Conclusions : Among the anthropometric variables studied, the waist / hip ratio (WHR) was the best variable to classify patients with and without severe liver damage, followed by the waist. Transaminases showed better performance than the anthropometric variables, TGP being the best, followed in order by AST and GGT.