Phase angle and non-alcoholic fatty liver disease before and after bariatric surgery

Joise Teixeira; Cláudio Augusto Marroni; Paula Rosales Zubiaurre; Ana Henz; Lais Faina; Lilian Kethelyn Pinheiro; Claudio Cora Mottin; Sabrina Alves Fernandes

doi:10.4254/wjh.v12.i11.1004

Phase angle and non-alcoholic fatty liver disease before and after bariatric surgery

World J Hepatol. 2020 Nov 27;12(11):1004-1019. doi: 10.4254/wjh.v12.i11.1004.

Authors

Joise Teixeira¹, Cláudio Augusto Marroni², Paula Rosales Zubiaurre³, Ana Henz⁴, Lais Faina⁵, Lilian Kethelyn Pinheiro⁴, Claudio Cora Mottin⁶, Sabrina Alves Fernandes⁷

Affiliations

¹ Department of Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90050170, RS, Brazil.
² Department of Gastroenterology and Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 91760470, RS, Brazil.
³ Department of Center of Morbid Obesity, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre 90610000, RS, Brazil.
⁴ Department of Nutrition, Centro Universitário Metodista (IPA), Porto Alegre 90420060, RS, Brazil.
⁵ Department of Vascular Surgery, Hospital Federal dos Servidores do Estado do Rio de Janeiro, Rio de Janeiro 20221161, RJ, Brazil.
⁶ Department of Obesity and Metabolic Syndrome Center, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre 90619-900, RS, Brazil.
⁷ Department of Nutrition, Centro Universitário Metodista (IPA), Porto Alegre 90420060, RS, Brazil. sabrina@drasabrinafernandes.com.

Abstract

Background: Obesity is a global health problem that is continuing to increase in the young population. In Brazil, the frequency of obesity in 2018 was 19.8%. Several comorbidities are directly associated with obesity, such as non-alcoholic fatty liver disease (NAFLD), which is considered the most common liver disorder in Western countries and affects up to 46% of adults. Bariatric surgery is effective in treating obesity and can improve NAFLD; however, the effect of bariatric surgery on body composition, phase angle (PA), and improving NAFLD needs to be further studied.

Aim: To analyze the PA in the postoperative period of bariatric surgery and to correlate it with changes in body composition and liver disease.

Methods: This study is a retrospective cohort study of the analysis of the medical records of patients undergoing bariatric surgery in a reference center of a teaching hospital in Porto Alegre over a 2-year period. Patients older than 18 years whose record contained all information relevant to the study were included. The data analyzed were body composition and PA through electrical bioimpedance and NAFLD through liver biopsy in the pre- and postoperative period. The level of significance adopted for the statistical analyses was 5%.

Results: We evaluated 379 patients with preoperative data. Regarding PA, 169 patients were analyzed, and 33 patients had liver biopsy pre- and postoperatively with NAFLD information. In total, 79.4% were female, with a mean age of 39.1 ± 10.6 years. The average body mass index (BMI) was 45.9 ± 7.5 kg/m². The PA showed a mean of 5.8 ± 0.62° in the preoperative period and a significant reduction in the postoperative period. A postoperative reduction in body composition data (skeletal muscle mass, fat percentage, fat mass, body cell mass, BMI and visceral fat area) was shown as well. Regarding liver disease, all patients presented a reduction in the degrees and stages of liver disease in the postoperative period, and some had no degree of liver disease at all.

Conclusion: PA decreased after bariatric surgery, with a direct correlation with weight loss and changes in body composition. The decrease in PA was not correlated with the improvement in NAFLD.

Keywords: Bariatric surgery; Body composition; Liver disease; Non-alcoholic fatty liver disease; Obesity; Phase angle.