Wei-Yu Kao1,2,3,4,5, I-Wei Chang6,7,8, Chi-Long Chen6,7, Chien-Wei Su4,5, Sheng Uei Fang2,3, Jui-Hsiang Tang2,3, Chun-Chao Chang1,2,3, Yu-Jia Chang9,10,11, Weu Wang12,13. 1. Graduate Institute of Clinical Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan. 3. Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Wuxing Street, Xinyi District, Taipei City, 110, Taiwan. 4. Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 5. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. 6. Department of Pathology, Taipei Medical University Hospital, Taipei, Taiwan. 7. Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 8. Departments of Pathology and Laboratory Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 9. Graduate Institute of Clinical Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. r5424012@tmu.edu.tw. 10. Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. r5424012@tmu.edu.tw. 11. Cancer Research Center, Taipei Medical University Hospital, Taipei, Taiwan. r5424012@tmu.edu.tw. 12. Division of Digestive Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan. wangweu@tmu.edu.tw. 13. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. wangweu@tmu.edu.tw.
Abstract
BACKGROUND: The prevalence rate of nonalcoholic fatty liver disease (NAFLD) has been reported in 74 to 90% of morbidly obese patients. This study aims to develop a scoring system that predicts significant liver fibrosis in morbidly obese patients. METHODS: This prospective cohort study involved 123 morbidly obese patients who underwent metabolic surgery at Taipei Medical University Hospital between October 2016 and June 2018. Wedge liver biopsy was performed during surgery, and significant liver fibrosis was defined as a fibrosis score ≧ 2. Ultrasonography and transient elastography were performed prior to surgery to assess the risk factors associated with significant liver fibrosis. RESULTS: Mean patient age was 35.5 years, mean body mass index (BMI) was 40.6 kg/m2, and 87 (70.7%) were female. Fibrosis staging revealed 28 (22.8%) at stage 2, 14 (11.4%) at stage 3, and 2 (1.6%) at stage 4. Patients were then separated into training (n = 73) and validation (n = 50) cohorts. Multivariate analysis revealed a liver stiffness measurement (LSM) > 7 kPa and aspartate aminotransferase/platelet ratio index (APRI) > 0.40 as independent factors associated with significant liver fibrosis among the training cohort. Fibroscan-base score weighted sum of (1 for presence of APRI > 0.40) + (2 for presence of LSM > 7 kPa) yielded the highest area under receiver operating curve (0.854, P = 0.0001; 0.785, P = 0.0002) compared with other non-invasive markers in the training and validation cohorts, respectively. CONCLUSION: We developed a simple, clinical scoring system incorporating Fibroscan and APRI to predict significant liver fibrosis in morbidly obese patients.
BACKGROUND: The prevalence rate of nonalcoholic fatty liver disease (NAFLD) has been reported in 74 to 90% of morbidly obese patients. This study aims to develop a scoring system that predicts significant liver fibrosis in morbidly obese patients. METHODS: This prospective cohort study involved 123 morbidly obese patients who underwent metabolic surgery at Taipei Medical University Hospital between October 2016 and June 2018. Wedge liver biopsy was performed during surgery, and significant liver fibrosis was defined as a fibrosis score ≧ 2. Ultrasonography and transient elastography were performed prior to surgery to assess the risk factors associated with significant liver fibrosis. RESULTS: Mean patient age was 35.5 years, mean body mass index (BMI) was 40.6 kg/m2, and 87 (70.7%) were female. Fibrosis staging revealed 28 (22.8%) at stage 2, 14 (11.4%) at stage 3, and 2 (1.6%) at stage 4. Patients were then separated into training (n = 73) and validation (n = 50) cohorts. Multivariate analysis revealed a liver stiffness measurement (LSM) > 7 kPa and aspartate aminotransferase/platelet ratio index (APRI) > 0.40 as independent factors associated with significant liver fibrosis among the training cohort. Fibroscan-base score weighted sum of (1 for presence of APRI > 0.40) + (2 for presence of LSM > 7 kPa) yielded the highest area under receiver operating curve (0.854, P = 0.0001; 0.785, P = 0.0002) compared with other non-invasive markers in the training and validation cohorts, respectively. CONCLUSION: We developed a simple, clinical scoring system incorporating Fibroscan and APRI to predict significant liver fibrosis in morbidly obese patients.
Authors: Robert P Myers; Gilles Pomier-Layrargues; Richard Kirsch; Aaron Pollett; Andres Duarte-Rojo; David Wong; Melanie Beaton; Mark Levstik; Pam Crotty; Magdy Elkashab Journal: Hepatology Date: 2011-11-18 Impact factor: 17.425
Authors: Stuart McPherson; Tim Hardy; Jean-Francois Dufour; Salvatore Petta; Manuel Romero-Gomez; Mike Allison; Claudia P Oliveira; Sven Francque; Luc Van Gaal; Jörn M Schattenberg; Dina Tiniakos; Alastair Burt; Elisabetta Bugianesi; Vlad Ratziu; Christopher P Day; Quentin M Anstee Journal: Am J Gastroenterol Date: 2016-10-11 Impact factor: 10.864
Authors: Ahmad Hassan Ali; Alhareth Al Juboori; Gregory F Petroski; Alberto A Diaz-Arias; Majid M Syed-Abdul; Andrew A Wheeler; Rama R Ganga; James B Pitt; Nicole M Spencer; Ghassan M Hammoud; R Scott Rector; Elizabeth J Parks; Jamal A Ibdah Journal: J Clin Med Date: 2022-02-23 Impact factor: 4.964
Authors: Saleh A Alqahtani; Pegah Golabi; James M Paik; Brian Lam; Amir H Moazez; Hazem A Elariny; Zachary Goodman; Zobair M Younossi Journal: Obes Surg Date: 2021-02-22 Impact factor: 4.129