Morbid obesity and nonalcoholic steatohepatitis: analysis of iron metabolism

Identifier:  TFG:2978

Handle: https://hdl.handle.net/20.500.11797/TFG2978

Authors:  Bujaldón Velasco, Marina

Abstract:
Introduction and objectives. The prevalence of obesity is increasing worldwide. Non-alcoholic fatty liver disease (NAFLD) stands out among the problems of obesity. The spectrum of NAFLD ranges from simple steatosis to non-alcoholic steatohepatitis (NASH). The aim was to analyse changes in iron metabolism in patients with morbid obesity, both with NASH and without NASH. We also investigated what happens to these patients one year after undergoing bariatric surgery. Methodology. We selected patients with morbid obesity who underwent bariatric surgery, control patients, and patients one year after they underwent bariatric surgery. During surgery, serum, plasma, and liver biopsy samples were obtained. With liver biopsy, iron was observed and quantified in the samples. With plasma and serum samples, routine biochemical analyses of iron metabolism were performed. Results. Histological analysis revealed that the livers of patients without NASH contained more iron than those patients with NASH. Regarding serum iron metabolism, we found that iron and ferritin were increased in obese patients with respect to the control group. In addition, foci of lobular inflammation increased with increasing concentration of iron, ferritin, and transferrin. The same occurred for the ballooning effect and fibrosis, both for iron and for transferrin. Conclusion. Iron is an important cofactor in the pathogenesis and progression of NASH. Increased ferritin and transferrin have been shown to be common during NASH. Fibrosis would be a feature of NASH that could be more closely linked to changes in iron, ferritin and transferrin concentrations.