Correlación entre marcadores serológicos y ecográficos en pacientes con hígado graso no alcohólico y diabetes mellitus tipo 2

Abstract

espanolIntroduccion: Los diabeticos tipo 2 tienen un alto riesgo de padecer higado graso no alcoholico. La deteccion e intervencion temprana podrian reducir el riesgo cardiovascular, prevenir sus complicaciones y reducir su progresion. El objetivo es evaluar la correlacion entre los marcadores por ecografia abdominal y marcadores serologicos indirectos en pacientes diabeticos tipo 2 con higado graso no alcoholico. Metodo: Se realizo un estudio descriptivo, correlacional y transversal. Se estudiaron 33 pacientes por ecografia abdominal para evaluar la severidad de la esteatosis hepatica. Los marcadores serologicos indirectos fueron glicemia, colesterol total, trigliceridos, alanino-transaminasa, aspartato-transaminasa y ganmaglutamil-transferasa. Se contrastaron los resultados de ambos marcadores mediante T de Student, prueba de ajuste de Kolmogorov y analisis de varianza. Resultados: La edad promedio fue de 54,9 ± 9,1 anos. Se observo con mas frecuencia marcador hiperecogenico moderado (45,5 %) con patron difuso. Los marcadores serologicos indirectos mas alterados fueron glicemia (n=29; 87,8%), trigliceridos (n=25; 75,8 %), colesterol total (n=22; 66,7) y alanino-transaminasa (n= 21; 63,6 %). Los niveles de glicemia y enzima ASAT ofrecieron valores de Rho Spearman de r=0,65 y r=0,61 respectivamente. Conclusion: El desarrollo del higado graso no alcoholico pareciera estar ligado a descompensacion metabolica cronica e insulinorresistencia. Los niveles de glicemia y enzima ASAT fueron los marcadores serologicos indirectos que presentaron la mayor correlacion estadistica con los grados de lesion hepatica diagnosticada por ecografia abdominal. Se recomienda el uso de modelos predictivos a partir de variables clinicas, marcadores serologicos indirectos y ecograficos en el diagnostico y seguimiento a pacientes con higado graso no alcoholico por su sencillez, y buena correlacion con tecnicas mas complejas. La estratificacion de riesgo con el empleo de dichos herramientas posibilita implementar medidas tempranas para reducir la morbimortalidad por causa cardiovascular EnglishIntroduction: Type 2 diabetics have a high risk of suffering from fatty liver disease alcoholic. Detection and early intervention may reduce cardiovascular risk, prevent their complications and reduce their progression. The objective is to evaluate the correlation between the markers by abdominal ultrasound and indirect serological markers in type 2 diabetic patients with non-alcoholic fatty liver. Method: A descriptive, correlational and transversal study was carried out. Thirty three patients were studied to evaluate the severity of hepatic steatosis by abdominal ultrasound. The indirect serological markers were glycemia, total cholesterol, triglycerides, alanine transaminase, aspartate transaminase and ganmaglutamyl transferase. The results of both markers by Student s T test, Kolmogorov adjustment test and variance analysis. Results: The average age was 54.9 ± 9.1 years. Moderate hyperechogenic marker (45.5%) with diffuse pattern was more frequently observed. The most altered indirect serological markers were glycemia (n = 29, 87.8%), triglycerides (n = 25, 75.8%), total cholesterol (n = 22,66.7) and alanine-transaminase (n = 21). 63.6%). The levels of glycemia and enzyme ASAT offered Rho Spearman values of r = 0.65 and r = 0.61 respectively. Conclusion: The development of nonalcoholic fatty liver appears to be linked to chronic metabolic decompensation and insulin resistance. The levels of glycemia and ASAT enzyme were the indirect serological markers that had the highest statistical correlation with the degrees of liver injury diagnosed by abdominal ultrasound. It is recommended the use of predictive models from clinical variables, Indirect and ultrasound serological markers in the diagnosis and follow-up of patients with non-alcoholic fatty liver for its simplicity, and good correlation with more techniques complex. Risk stratification with the use of these tools enables implement early measures to reduce morbidity and mortality due to cardiovascular causes.