Prevalência dos achados ultrassonográficos sugestivo de doença hepática gordurosa não alcóolica em jovens da graduação médica

Abstract

Research regarding alcoholic fatty liver disease (NAFLD) has been progressively realized, a fact which follows from the worrying growth of its worldwide prevalence and its potential to progress to more serious chronic forms, such as fibrosis and cirrhosis, and consequently liver failure . This research examined the prevalence of sonographic findings suggestive of NAFLD in young medical students of a private higher education institution in the city of Montes Claros, MG, establishing a relationship between these findings and anthropometric and laboratory data of the subjects studied, considering that this is a population potentially exposed to disease-related risk factors such as poor dietary habits and a sedentary lifestyle, have engaged in labor activity of long duration. The population consisted of 148 young people aged ≥ 18 and < 40anos, underwent ultrasonography (US), anthropometric and laboratory evaluation. Anthropometric assessment was based on body mass index (BMI) and the laboratory was done by analyzing the lipid profile (triglycerides, total cholesterol, HDL and LDL) and hepatic enzyme markers (aspartate aminotransferase, alanine aminotransferase - AST and ALT- and ferritin). The prevalence of NAFLD and overweight/obesity (BMI ≥ 25kg /m 2 ) was 10.1% and 27.2%, respectively. Overweight/obesity was associated with NAFLD (OR 3,6 - CI95%: 1,2 -10,6), with a statistically significant difference (p = 0,016) between the group with US abnormal and BMI ≥ 25 and onde with normal BMI and US suggestive of disease. There were statistically significant differences between mean BMI, considering gender, age and US suggestive of disease, with a mean BMI of 25.1 kg/m2 in males (p = 0.000), 25kg/m 2 in those aged above 25 years (p = 0.001) and 25,2Kg/m 2 abnormal US group (p = 0.011). Dyslipidemia was detected in 42.6%, with 16,9% of hypertriglyceridemia, 16.2% of low levels of HDL (high density lipoprotein) and 11.5% to increased levels of LDL (low density lipoproteins). There was found association between laboratory markers of lipid profile (total cholesterol, HDL and triglycerides) and US suggestive of disease with OR 2,3 (CI95%: 0,7-8,1) to total cholesterol, OR 2,0 (CI95%: 0,6-7,1) to HDL e OR 2,8 (IC 95%: 0,9-9,1) to triglycerides. although only the latter association was considered statistically borderline, with p = 0.073. About hepatic laboratory markers, 50% of students with abnormal levels of ALT showed US suggestive of NAFLD, compared to 9.6% who exhibited normal levels of the marker and changed US, verifying association between the variable (OR 9,4), although not statistically significant, since the confidence interval was wide (CI95%:0.6 -159.1), wich can be explain for the small sample in this group, limiting therefore this data. There was no association between the disease and other liver markers, represented by ferritin and AST. This study’s results agree with the literature mainly about association between NAFLD, overweight/obesity and dyslipidemia, pointing to the need for early investigation of NAFLD in subjects exposed to established risk factors. For this purpose ultrasonography stands out as a useful diagnostic method, because it is not invasive, easy to perform, low cost, wide availability of public services and with good reproducibility for the initial screening of the disease, especially when considering the use on a population scale.