This study confirms the association between liver retinol and degree of NAFLD, underscoring the need for further research in this area, to identify which patients might benefit from supplementation of vitamin A.
The high inadequacy of retinol and beta-carotene nutritional status in the sample, with a higher inadequacy in those with NAFLD, suggests an increase in the utilization of vitamin A in this group related to the fight against the oxidative stress to what they are exposed to. The significant association between retinol and beta-carotene with IR supports the hypothesis that vitamin A may have a protector effect on IR pathogenesis.
High prevalence of VAD in the preoperative period and in 30 and 180 postoperative days, even during supplementation, with higher inadequacy of beta-carotene in all the three studied time periods, probably occurred because of its bioconversion to retinol due to the increased demand to which those individuals were exposed. It is suggested that the oral intake supplementation does not present the expected impact, and the need of assessing the nutritional status of vitamin A in the pre- and postoperative Roux-en-Y gastric bypass is emphasized. High prevalence of VAD in T1, with severity in T2 and T3, corroborates the utilization of the cutoff of <1.05 micromol/L as a VAD marker in the studied segment and reinforces its utilization as a tool in clinical practice to identify VAD in morbid obese patients who underwent bariatric surgery.
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