-Background -Vitamin A participates in several essentials functions in the human body and their serum concentrations may be decreased in non-transmissible diseases. Aim -To assess the relationship of the nutritional status of Vitamin A through the serum concentrations of retinol and beta carotene, with regression of hepatic steatosis in individuals who undergone Roux-en-Y gastric bypass surgery for treatment of class III obesity. Methods -Were included 30 individuals, male and female, submitted to Roux-en-Y gastric bypass for treatment of class III obesity, who were diagnosed through an abdominal ultrasonography as presenting hepatic steatosis. From the result of an ultrasonography screened six months after the surgical procedure those subjects were divided into two groups: group 1 -patients with steatosis detected in the ultrasonography (16 subjects) and group 2 -patients without steatosis detected in the ultrasonography (14 subjects). Before and six months after the surgery, were carried out anthropometrical analyses and biochemical exams (basal insulin, glicemy, Homeostasis Model Assessment Index (HOMA IR), cholesterol, HDL, LDL, triglycerides, AST, ALT, Gamma-GT, albumin, total bilirubin, retinol, and beta carotene. Results -The individuals presented an average weight loss of 35.05 + 10.47 (p<0.01) and a decrease in the Body Mass Index (BMI) of 11.6 + 4.99 Kg/m² (p<0.01). After six months, all the biochemical exams presented a significant decrease in their basal concentrations (p<0.05). In the post-operative period the group 2 (without steatosis) presented concentrations significantly lower (p<0.05) in the following variables: weight, BMI, AST, ALT, Gamma-GT, HOMA IR, basal insulin. The albumin serum concentrations presented close average values, with no significant difference in the two periods evaluated. In the assessment of retinol and beta carotene, higher serum concentrations and a small decrease in relation to the concentrations of the pre-operative period in the group without steatosis were observed, however, no statistical difference was found. Conclusion -An adequate nutritional status of vitamin A might contribute in the improvement of the hepatic esteatosis after Roux-en-Y gastric bypass for class III obesity treatment. ABCDDV/879RESUMO -Racional -A vitamina A participa de várias funções primordiais no organismo humano e as suas concentrações séricas podem estar diminuídas nas doenças crônicas não transmissíveis. Objetivo -Avaliar a relação entre o estado nutricional da vitamina A, e a regressão da esteatose hepática em indivíduos submetidos à gastroplastia em Y-de-Roux para tratamento da obesidade classe III.
O carcinoma hepatocelular (CHC) é um tumor maligno de baixo prognóstico. Evidências demonstrando a relação entre nutrição e risco de desenvolvimento de câncer são freqüentes na literatura. Vários estudos epidemiológicos têm sugerido que o consumo freqüente de alimentos com elevado teor de carotenóides e vitamina A está associado ao risco reduzido de desenvolvimento de certos tipos de neoplasias. Objetivando verificar o volume de evidências científicas da atuação da vitamina A e dos carotenóides no processo de hepatocarcinogênese, foram revisados dados na literatura. Diversos estudos realizados até o momento apontam os retinóides como agentes que controlam tanto a diferenciação como a proliferação celular, podendo, dessa forma, serem úteis na quimioprevenção do câncer. Os mecanismos propostos pelos quais a vitamina A e os carotenóides exercem sua ação protetora incluem o aumento da função imunológica, dos canais de comunicação intercelular e da atividade antioxidante, apresentando ação inibitória nas lesões pré-neoplásicas. A quimioprevenção por meio da vitamina A ou carotenóides, pode resultar em melhor prognóstico e aumento de sobrevida para população de alto risco, tais como, pacientes com cirrose e CHC.
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