BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GD) share common risk factors. There are no firm recommendations regarding screening of NAFLD in patients at risk. Our aim was to assess the prevalence of and factors associated with NAFLD in a cohort of patients operated for symptomatic GD and evaluate the usefulness of routine liver biopsy. METHODS: Ninety-five consecutive patients underwent a liver biopsy at the end of a standard laparoscopic cholecystectomy for symptomatic GD. Clinical, biochemical, demographic, and anthropometric variables were obtained prospectively. RESULTS: Fifty-two patients (55%) had biopsies compatible with NAFLD. These patients were classified according to the system proposed by Brunt et al. as follows: grade I, n = 27 (52%); grade II, n = 15 (29%); grade III, n = 10 (19%). Two grade III patients had zone III focal perisinusoidal fibrosis and three had overt cirrhosis. Only 13% of subjects had a suspected diagnosis of NAFLD preoperatively. In multivariate logistic regression, only obesity was significantly associated with NAFLD. There were no complications or mortality. DISCUSSION: Fifty-five percent of patients with GD have associated NAFLD. Awareness of this association may result in an earlier diagnosis. The high prevalence of NAFLD in patients with GD may justify routine liver biopsy during cholecystectomy to establish the diagnosis, stage, and possible direct therapy.
BACKGROUND:Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GD) share common risk factors. There are no firm recommendations regarding screening of NAFLD in patients at risk. Our aim was to assess the prevalence of and factors associated with NAFLD in a cohort of patients operated for symptomatic GD and evaluate the usefulness of routine liver biopsy. METHODS: Ninety-five consecutive patients underwent a liver biopsy at the end of a standard laparoscopic cholecystectomy for symptomatic GD. Clinical, biochemical, demographic, and anthropometric variables were obtained prospectively. RESULTS: Fifty-two patients (55%) had biopsies compatible with NAFLD. These patients were classified according to the system proposed by Brunt et al. as follows: grade I, n = 27 (52%); grade II, n = 15 (29%); grade III, n = 10 (19%). Two grade III patients had zone III focal perisinusoidal fibrosis and three had overt cirrhosis. Only 13% of subjects had a suspected diagnosis of NAFLD preoperatively. In multivariate logistic regression, only obesity was significantly associated with NAFLD. There were no complications or mortality. DISCUSSION: Fifty-five percent of patients with GD have associated NAFLD. Awareness of this association may result in an earlier diagnosis. The high prevalence of NAFLD in patients with GD may justify routine liver biopsy during cholecystectomy to establish the diagnosis, stage, and possible direct therapy.
Authors: Raphael B Merriman; Linda D Ferrell; Marco G Patti; Shiobhan R Weston; Mark S Pabst; Bradley E Aouizerat; Nathan M Bass Journal: Hepatology Date: 2006-10 Impact factor: 17.425
Authors: Pouneh Mofrad; Melissa J Contos; Mahmadul Haque; Carol Sargeant; Robert A Fisher; Velimir A Luketic; Richard K Sterling; Mitchell L Shiffman; Richard T Stravitz; Arun J Sanyal Journal: Hepatology Date: 2003-06 Impact factor: 17.425
Authors: Z M Younossi; T Gramlich; Y C Liu; C Matteoni; M Petrelli; J Goldblum; L Rybicki; A J McCullough Journal: Mod Pathol Date: 1998-06 Impact factor: 7.842
Authors: Kamal K Mahawar; Chetan Parmar; Yitka Graham; Ayman Abouleid; William R J Carr; Neil Jennings; Norbert Schroeder; Peter K Small Journal: Obes Surg Date: 2016-01 Impact factor: 4.129
Authors: Pirjo Käkelä; Ville Männistö; Imre Ilves; Maija Vaittinen; Milla-Maria Tauriainen; Matti Eskelinen; Helena Gylling; Hannu Paajanen; Jussi Pihlajamäki Journal: Obes Surg Date: 2017-05 Impact factor: 4.129