Foi evidenciada alta prevalência de DHGNA e de EHNA em grupo de obesos mórbidos, adultos, selecionados para cirurgia bariátrica, sem evidência de comprometimento hepático prévio. A prevalência da EHNA foi particularmente elevada quando comparada a outros estudos que também utilizaram critérios mais restritos como os empregados neste estudo. Predominou o grau leve de EHNA com baixa prevalência de fibrose perissinusoidal, tendo a fibrose portal isolada, inclusive, mostrado números mais expressivos nesta amostra.
A γGT foi fator independentemente associado ao grau de esteatose. Por sua associação com a resistência insulínica, estes resultados alertam para uma maior relevância desta enzima no acompanhamento dos portadores desta entidade.
Na análise de associação não foram identificados fatores independentemente associados à EHNA, podendo as características da amostra ter participação nestes resultados. Entre estas características destaca-se a homogeneidade da mesma, estando as variáveis demográficas e antropométricas uniformente distribuídas. Deve ser considerado ainda o poder da amostragem, diante do número de variáveis analisadas.
Pode-se concluir, ao final, que a DHGNA, forma mais ampla da doença, e a EHNA, etapa mais avançada da doença, apresentaram alta prevalência nesta categoria de obesos, ocorrendo sem manifestações clínicas e laboratoriais relevantes, denotando curso silencioso, exigindo acompanhamento diligente por parte do profissional médico que lida com estes pacientes.
Torna-se aconselhável que a biópsia hepática passe a ser introduzida como uma etapa do procedimento cirúrgico neste grupo, com o fito de alertar quanto a complicações que possam advir no pós-operatório imediato e tardio permitindo orientação mais pertinente quanto ao grau de acompanhamento futuro que este grupo de pacientes possa merecer.
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