Prevalence and Factors Associated with Hepatic Iron Overload in Obese Individuals Undergoing Bariatric Surgery: a Cross-
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Prevalence and Factors Associated with Hepatic Iron Overload in Obese Individuals Undergoing Bariatric Surgery: a Cross-Sectional Study Rafael N. Jesus 1 & Guilherme H. Callejas 1 & Matheus M. Concon 1 & João G. R. Braga 1 & Rodolfo A. Marques 1 & Felipe D. M. Chaim 1 & Martinho A. Gestic 1 & Murillo P. Utrini 1 & Almino C. Ramos 1 & Elinton A. Chaim 1 & Everton Cazzo 1 Received: 24 August 2020 / Revised: 17 September 2020 / Accepted: 22 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Slight to moderate hepatic iron overload (HIO) can be found in cases of liver disease, including non-alcoholic fatty liver disease (NAFLD), but the mechanism is not completely understood, as well as its relationship with obesity. Objective To determine the prevalence of HIO assessed through histopathological examination in obese individuals undergoing bariatric surgery and to identify correlations between this condition and demographic, anthropometric, clinical, laboratory, and NAFLD-related aspects. Methods This is a cross-sectional study which enrolled individuals undergoing bariatric surgery from January 2018 to February 2019 at a tertiary university hospital. NAFLD and HIO were assessed through histological examination. Results Of 125 individuals, 87.2% were female and the average age was 38.8 ± 9.2 years. The average BMI was 37.2 ± 3.1 kg/ m2. NAFLD was present in 66.4% and HIO in 17.6%, with 63.6% of patients with overload classified as mild (grade I) and 22.7% moderate (grade II). HIO was significantly more frequent in males (p = 0.003) and was significantly associated with higher levels of glucose (92.1 ± 28.4 vs. 80.7 ± 39.6; p = 0.02), ferritin (385.5 ± 290.9 vs. 131.6 ± 99.7; p < 0.0001), serum iron (82.4 ± 35.7 vs. 66.6 ± 25.1; p = 0.03), glutamic-oxaloacetic transaminase (27.3 ± 19.5 vs. 20.6 ± 8.8; p = 0.02), and glutamic-pyruvic transaminase (37.6 ± 36.4 vs. 24.6 ± 16.3; p = 0.01). Multivariate analysis showed that HIO intensity was significant and independently associated with ferritin levels (R = 0.19; p = 0.01), serum iron (R = 0.25; p < 0.0001), blood glucose (R = 0.16; p = 0.001), and total cholesterol (R = − 0.17; p < 0.0001). Conclusion In obese individuals, HIO presented a high prevalence and was associated with higher levels of ferritin, serum iron, glucose, and transaminases; lower levels of total cholesterol; and male gender. Keywords Iron overload . Obesity . Insulin resistance . Bariatric surgery . Iron metabolism disorders
Introduction Iron is a vital micronutrient for humans and is part of multiple physiological processes. It has a fundamental role linked to hemoproteins: hemoglobin and myoglobin in the transport of oxygen, catalase and peroxidase in the metabolism of oxygen, and cytochromes in the transport of electrons and mitochondrial respiration. In addition, it has a role in DNA synthesis,
* Everton Cazzo [email protected] 1
Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICA
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