Abstract:
Fibrosis refers to the excessive accumulation of extracellular matrix, which is associated with metabolic dysfunction in white adipose tissue (WAT) in obesity. Factors such as energy imbalance and hepatic steatosis are related to the development and progression of this condition. Objective: To investigate the association between hepatic markers and dietary intake with the presence of fibrosis in subcutaneous and visceral adipose tissue in women with severe obesity. Methods: This is a cross-sectional study involving 49 women with Body Mass Index (BMI) ≥ 40 kg/m² who underwent bariatric surgery (BS). Anthropometric data, biochemical tests, dietary intake, WAT samples, as well as aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were collected. Dietary intake was assessed using a 24-hour dietary recall and the Food Frequency Questionnaire (FFQ), ELSA-Brasil version (2013). Foods were categorized according to their level of processing, and consumption frequency was converted into a score. For the analysis of fibrosis in WAT, samples of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were collected, stained with picrosirius red, and analyzed by the percentage of red staining (fibrosis). The sample was divided into groups according to the median percentage of fibrosis in each adipose tissue compartment. Results: The sample had a mean age of 40.18 ± 8.37 years and a mean BMI of 50.51 ± 6.88 kg/m². No significant differences were observed in the presence of fibrosis across different WAT depots. A higher score in the Hepatic Steatosis Index (HSI) was associated with an increased risk of fibrosis in VAT. No significant associations were found between fibrosis and dietary intake according to the level of food processing. However, higher protein intake was associated with lower fibrosis in VAT. Conclusion: Women with severe obesity and a lower percentage of fibrosis seem to have less liver damage, according to the HSI marker. In terms of diet, higher protein intake appears to have a beneficial role in visceral adipose tissue.
