Abstract：
BACKGROUND: Given the importance of fibrosis in the progression of non-alcoholic fatty liver disease (NAFLD), identifying biochemical and histopathological aspects associated with its severity is important to determine the course of disease in high-risk populations.
OBJECTIVE: The study aims to investigate correlations between biochemical and histopathological variables associated with the occurrence and severity of NAFLD-related liver fibrosis in individuals with obesity.
METHODS: This is a cross-sectional study which enrolled 171 individuals who underwent bariatric surgery at a tertiary university hospital. Clinical, laboratory, and histopathological hepatic characteristics were analyzed. Univariate and multivariate analyses were carried out to identify factors associated with the outcomes studied (severity of fibrosis staging) through simple and multiple regression models.
RESULTS: Female were 87.7%, and the mean age was 38.4 ± 9.3 years. The most common histopathological abnormalities were macrovesicular steatosis (74.9%) and hepatocellular ballooning (40.4%). In the histopathological univariate analysis, liver fibrosis significantly correlated with severities of microvesicular steatosis (p = 0.003), lobular inflammation (p = 0.001), and NAS (p < 0.001). In the multivariate analysis, the degrees of microvesicular steatosis (p < 0.001) and NAS (p < 0.001) independently correlated with fibrosis severity. In the univariate biochemical analysis, fibrosis severity significantly correlated with levels of hemoglobin A1c (p = 0.004) and glucose (p = 0.01). In the multivariate analysis, glucose levels independently correlated with liver fibrosis degree (p = 0.007).
CONCLUSIONS: Significant and independent associations were observed between the intensities of microvesicular steatosis, NAS, and glucose levels and the severity degree of liver fibrosis in individuals with obesity.
OBJECTIVE: The study aims to investigate correlations between biochemical and histopathological variables associated with the occurrence and severity of NAFLD-related liver fibrosis in individuals with obesity.
METHODS: This is a cross-sectional study which enrolled 171 individuals who underwent bariatric surgery at a tertiary university hospital. Clinical, laboratory, and histopathological hepatic characteristics were analyzed. Univariate and multivariate analyses were carried out to identify factors associated with the outcomes studied (severity of fibrosis staging) through simple and multiple regression models.
RESULTS: Female were 87.7%, and the mean age was 38.4 ± 9.3 years. The most common histopathological abnormalities were macrovesicular steatosis (74.9%) and hepatocellular ballooning (40.4%). In the histopathological univariate analysis, liver fibrosis significantly correlated with severities of microvesicular steatosis (p = 0.003), lobular inflammation (p = 0.001), and NAS (p < 0.001). In the multivariate analysis, the degrees of microvesicular steatosis (p < 0.001) and NAS (p < 0.001) independently correlated with fibrosis severity. In the univariate biochemical analysis, fibrosis severity significantly correlated with levels of hemoglobin A1c (p = 0.004) and glucose (p = 0.01). In the multivariate analysis, glucose levels independently correlated with liver fibrosis degree (p = 0.007).
CONCLUSIONS: Significant and independent associations were observed between the intensities of microvesicular steatosis, NAS, and glucose levels and the severity degree of liver fibrosis in individuals with obesity.
摘要：
背景：考虑到纤维化在非酒精性脂肪性肝病（NAFLD）进展中的重要性，确定与其严重程度相关的生化和组织病理学方面对于确定高危人群的病程非常重要.
目的：本研究旨在探讨肥胖个体中与NAFLD相关肝纤维化的发生和严重程度相关的生化和组织病理学变量之间的相关性。
方法：这是一项横断面研究，纳入了171名在三级大学医院接受减肥手术的患者。临床,实验室,并对肝脏组织病理学特征进行分析。通过简单和多元回归模型进行单变量和多变量分析，以确定与研究结果相关的因素（纤维化分期的严重程度）。
结果：女性占87.7%，平均年龄为38.4±9.3岁。最常见的组织病理学异常是大泡性脂肪变性（74.9％）和肝细胞气球样变性（40.4％）。在组织病理学单变量分析中，肝纤维化与微泡脂肪变性的严重程度显着相关（p=0.003），小叶炎症（p=0.001），和NAS（p<0.001）。在多变量分析中，微囊性脂肪变性(p<0.001)和NAS(p<0.001)的程度与纤维化严重程度独立相关。在单变量生化分析中，纤维化严重程度与血红蛋白A1c(p=0.004)和葡萄糖(p=0.01)水平显著相关.在多变量分析中，血糖水平与肝纤维化程度独立相关（p=0.007）。
结论：在微泡脂肪变性的强度之间观察到显著和独立的关联，NAS,肥胖个体的血糖水平和肝纤维化的严重程度。
目的：本研究旨在探讨肥胖个体中与NAFLD相关肝纤维化的发生和严重程度相关的生化和组织病理学变量之间的相关性。
方法：这是一项横断面研究，纳入了171名在三级大学医院接受减肥手术的患者。临床,实验室,并对肝脏组织病理学特征进行分析。通过简单和多元回归模型进行单变量和多变量分析，以确定与研究结果相关的因素（纤维化分期的严重程度）。
结果：女性占87.7%，平均年龄为38.4±9.3岁。最常见的组织病理学异常是大泡性脂肪变性（74.9％）和肝细胞气球样变性（40.4％）。在组织病理学单变量分析中，肝纤维化与微泡脂肪变性的严重程度显着相关（p=0.003），小叶炎症（p=0.001），和NAS（p<0.001）。在多变量分析中，微囊性脂肪变性(p<0.001)和NAS(p<0.001)的程度与纤维化严重程度独立相关。在单变量生化分析中，纤维化严重程度与血红蛋白A1c(p=0.004)和葡萄糖(p=0.01)水平显著相关.在多变量分析中，血糖水平与肝纤维化程度独立相关（p=0.007）。
结论：在微泡脂肪变性的强度之间观察到显著和独立的关联，NAS,肥胖个体的血糖水平和肝纤维化的严重程度。
