Relação entre o estado nutricional de vitamina a e a regressão da esteatose hepática após gastroplastia em Y- de- Roux para tratamento da obesidade classe III

Abstract

-Background -Vitamin A participates in several essentials functions in the human body and their serum concentrations may be decreased in non-transmissible diseases. Aim -To assess the relationship of the nutritional status of Vitamin A through the serum concentrations of retinol and beta carotene, with regression of hepatic steatosis in individuals who undergone Roux-en-Y gastric bypass surgery for treatment of class III obesity. Methods -Were included 30 individuals, male and female, submitted to Roux-en-Y gastric bypass for treatment of class III obesity, who were diagnosed through an abdominal ultrasonography as presenting hepatic steatosis. From the result of an ultrasonography screened six months after the surgical procedure those subjects were divided into two groups: group 1 -patients with steatosis detected in the ultrasonography (16 subjects) and group 2 -patients without steatosis detected in the ultrasonography (14 subjects). Before and six months after the surgery, were carried out anthropometrical analyses and biochemical exams (basal insulin, glicemy, Homeostasis Model Assessment Index (HOMA IR), cholesterol, HDL, LDL, triglycerides, AST, ALT, Gamma-GT, albumin, total bilirubin, retinol, and beta carotene. Results -The individuals presented an average weight loss of 35.05 + 10.47 (p<0.01) and a decrease in the Body Mass Index (BMI) of 11.6 + 4.99 Kg/m² (p<0.01). After six months, all the biochemical exams presented a significant decrease in their basal concentrations (p<0.05). In the post-operative period the group 2 (without steatosis) presented concentrations significantly lower (p<0.05) in the following variables: weight, BMI, AST, ALT, Gamma-GT, HOMA IR, basal insulin. The albumin serum concentrations presented close average values, with no significant difference in the two periods evaluated. In the assessment of retinol and beta carotene, higher serum concentrations and a small decrease in relation to the concentrations of the pre-operative period in the group without steatosis were observed, however, no statistical difference was found. Conclusion -An adequate nutritional status of vitamin A might contribute in the improvement of the hepatic esteatosis after Roux-en-Y gastric bypass for class III obesity treatment. ABCDDV/879RESUMO -Racional -A vitamina A participa de várias funções primordiais no organismo humano e as suas concentrações séricas podem estar diminuídas nas doenças crônicas não transmissíveis. Objetivo -Avaliar a relação entre o estado nutricional da vitamina A, e a regressão da esteatose hepática em indivíduos submetidos à gastroplastia em Y-de-Roux para tratamento da obesidade classe III.

Analysis of obese patients' medical conditions in the pre and postoperative periods of bariatric surgery

“…Hepatic steatosis, identified by elevated levels of AST, ALT, GGT and biopsy specimens, also showed reduction after bariatric surgery. Other authors also observed a 46.6% reduction in steatosis among the individuals studied [24][25][26][27] . A meta-analysis carried out in the United Kingdom indicated a reduction of liver enzymes, considered markers of liver function and liver damage, statistically associated with the reduction of hepatic steatosis shortly after surgery 25 .…”

Coverage and educational actions related to the national vitamin A supplementation program: a study in children from the state of Alagoas

“…Vitamin A is an essential micronutrient in several physiological processes in the human body, being necessary for the adequate functioning of the immune system, visual acuity, cell proliferation/differentiation, and gene expression. 1 , 2 , 3 , 4 Despite universal susceptibility, its deficiency is more frequent in children under five years, pregnant women, and lactating women, which is why these groups are considered biologically more vulnerable to this nutritional deficiency. 5…”

Nutritional repercussions in patients submitted to bariatric surgery

“…It is noticeable that there are not many publications in the literature discussing the association between nutritional disorders and quality of life with weight loss 5 , 8 , 21 . So, this study aims to investigate the nutritional disorders in patients submitted to bariatric surgeries and its connections with weight loss and quality of life.…”