BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are conditions gaining increasing recognition in hepatology as a potential cause of cirrhosis and end-stage liver disease. Obesity is one of the main risk factors. The aims of this study were to determine the frequency of NAFLD in obese patients and to identify variables that predict NASH. METHODS: A prospective study was conducted of obese patients undergoing gastric bypass over a 20-month period. Assessment included liver function tests and evaluation of insulin resistance with the homeostatic model assessment (HOMA-IR). Liver biopsy was performed in all patients at the time of surgery. Clinical and biochemical variables were analyzed using a multivariate analysis to identify independent predictors of NASH. RESULTS: 127 consecutive patients were included (62% female, 38% male, mean age 40+/-11 years, mean body mass index 42+/-6 kg/m(2)). Arterial hypertension was present in 52 patients (41%) and type 2 diabetes in 18 (14%). NAFLD was confirmed in 80 patients (63%), 47 (37%) had simple steatosis, and 33 (26%) had NASH. Cirrhosis was found in 2 patients corresponding to 1.6% of the total population. On multivariate analysis, AST >31 (IU/L) (OR 3.38, CI 1.17-9.8) and HOMA-IR >5.8 (OR 4.18, CI 1.39-12.49) independently predicted NASH. CONCLUSIONS: NAFLD is highly prevalent in morbidly obese patients. A high proportion of these patients exhibit NASH on histological examination. Insulin resistance represents the main predictor of NASH.
BACKGROUND:Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are conditions gaining increasing recognition in hepatology as a potential cause of cirrhosis and end-stage liver disease. Obesity is one of the main risk factors. The aims of this study were to determine the frequency of NAFLD in obesepatients and to identify variables that predict NASH. METHODS: A prospective study was conducted of obesepatients undergoing gastric bypass over a 20-month period. Assessment included liver function tests and evaluation of insulin resistance with the homeostatic model assessment (HOMA-IR). Liver biopsy was performed in all patients at the time of surgery. Clinical and biochemical variables were analyzed using a multivariate analysis to identify independent predictors of NASH. RESULTS: 127 consecutive patients were included (62% female, 38% male, mean age 40+/-11 years, mean body mass index 42+/-6 kg/m(2)). Arterial hypertension was present in 52 patients (41%) and type 2 diabetes in 18 (14%). NAFLD was confirmed in 80 patients (63%), 47 (37%) had simple steatosis, and 33 (26%) had NASH. Cirrhosis was found in 2 patients corresponding to 1.6% of the total population. On multivariate analysis, AST >31 (IU/L) (OR 3.38, CI 1.17-9.8) and HOMA-IR >5.8 (OR 4.18, CI 1.39-12.49) independently predicted NASH. CONCLUSIONS: NAFLD is highly prevalent in morbidly obesepatients. A high proportion of these patients exhibit NASH on histological examination. Insulin resistance represents the main predictor of NASH.
Authors: Margarita Pizarro; Nancy Solís; Pablo Quintero; Francisco Barrera; Daniel Cabrera; Pamela Rojas-de Santiago; Juan P Arab; Oslando Padilla; Juan C Roa; Han Moshage; Alexander Wree; Eugenia Inzaugarat; Ariel E Feldstein; Carlos E Fardella; Rene Baudrand; Arnoldo Riquelme; Marco Arrese Journal: Liver Int Date: 2015-02-23 Impact factor: 5.828
Authors: Nathalie C Leite; Cristiane A Villela-Nogueira; Claudia R L Cardoso; Gil F Salles Journal: World J Gastroenterol Date: 2014-07-14 Impact factor: 5.742
Authors: Anthony Petrick; Peter Benotti; G Craig Wood; Christopher D Still; William E Strodel; John Gabrielsen; David Rolston; Xin Chu; George Argyropoulos; Anna Ibele; Glenn S Gerhard Journal: Obes Surg Date: 2015-12 Impact factor: 4.129
Authors: Dennis M Hedderich; Till Hasenberg; Stefan Haneder; Stefan O Schoenberg; Özlem Kücükoglu; Ali Canbay; Mirko Otto Journal: Obes Surg Date: 2017-07 Impact factor: 4.129