OBESITY MAY ACTUALLY BE A PRECIRRHOTIC CONDITION IN ADULTS

Background: There may be some significant relationships between the umbilical hernia, obesity, and cirrhosis during the process of metabolic syndrome in adults. Method: Consecutive patients with an umbilical hernia and/or a surgical repair history of the umbilical hernia were included. Results: There are 46 patients with the umbilical hernia with a mean age of 62.0 years, and 73.9% of them were female. Body mass index was higher in the hernia patients (33.6 versus 29.1 kg/m2, p= 0.000). Although the prevalence of hypertension (HT) was also higher in the hernia group (50.0% versus 27.3%, p<0.01), mean values of triglycerides and low density lipoproteins and prevalence of white coat hypertension (WCH) were lower in them (p<0.05 for all). Although prevalences of diabetes mellitus (DM) and coronary heart disease (CHD) were also higher in the hernia patients, the differences were nonsignificant, probably due to the small sample size of the hernia group. Conclusion: There may be some significant relationships between the umbilical hernia, obesity, cirrhosis, and other endpoints of the metabolic syndrome including HT, DM, and CHD, probably on the bases of prolonged inflammatory, atherosclerotic, and pressure effects of excessive fat tissue on abdominal wall muscles. The inverse relationships between obesity and hypertriglyceridemia and hyperbetalipoproteinemia may be explained by the hepatic fat accumulation, inflammation, and fibrosis induced relatively lost hepatic functions in obesity. Similarly, the inverse relationship between obesity and WCH may be explained by progression of WCH into overt HT in obesity. So obesity may actually be a precirrhotic condition in adults. Key words: Obesity, cirrhosis, metabolic syndrome, umbilical hernia, hepatosteatosis, atherosclerosis, end-organ insufficiency