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Predictors of nonalcoholic steatohepatitis and advanced fibrosis in morbidly obese patients.
Obes Surg 2005; 15(3):310-5OS

Abstract

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is a common form of chronic liver disease in the United States. It is commonly associated with the components of the metabolic syndrome including obesity. From the spectrum of NAFLD, only patients with nonalcoholic steatohepatitis (NASH) have been convincingly shown to have a potential for progression to cirrhosis. We report the prevalence of NAFLD and NASH as well as predictors of NASH and advanced fibrosis in morbidly obese patients.

METHODS

212 consecutive patients who underwent bariatric surgery were enrolled in the study. A liver biopsy was performed at the time of the surgery. Causes of chronic liver disease other than NAFLD were excluded by clinical and laboratory evaluation.

RESULTS

The prevalence of NAFLD was 93%. Of those with NAFLD, 26% had NASH. 17 patients (9%) had advanced fibrosis (i.e., bridging fibrosis or cirrhosis). Male gender, AST, and type 2 diabetes mellitus were independently associated with NASH. Waistto-hip ratio, AST, and focal hepatocyte necrosis on liver biopsy were independently associated with advanced fibrosis. Interestingly, while AST was associated with NASH and advanced fibrosis, the majority of the patients with either NASH or advanced fibrosis had normal AST.

CONCLUSIONS

NAFLD and NASH are very common in morbidly obese patients undergoing bariatric surgery. Features associated with the metabolic syndrome and liver cell injury are independently associated with either NASH or advanced fibrosis.

Authors+Show Affiliations

Center for Liver Diseases, Inova Fairfax Hospital, Washington, DC, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15826462

Citation

Ong, Janus P., et al. "Predictors of Nonalcoholic Steatohepatitis and Advanced Fibrosis in Morbidly Obese Patients." Obesity Surgery, vol. 15, no. 3, 2005, pp. 310-5.
Ong JP, Elariny H, Collantes R, et al. Predictors of nonalcoholic steatohepatitis and advanced fibrosis in morbidly obese patients. Obes Surg. 2005;15(3):310-5.
Ong, J. P., Elariny, H., Collantes, R., Younoszai, A., Chandhoke, V., Reines, H. D., ... Younossi, Z. M. (2005). Predictors of nonalcoholic steatohepatitis and advanced fibrosis in morbidly obese patients. Obesity Surgery, 15(3), pp. 310-5.
Ong JP, et al. Predictors of Nonalcoholic Steatohepatitis and Advanced Fibrosis in Morbidly Obese Patients. Obes Surg. 2005;15(3):310-5. PubMed PMID: 15826462.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of nonalcoholic steatohepatitis and advanced fibrosis in morbidly obese patients. AU - Ong,Janus P, AU - Elariny,Hazem, AU - Collantes,Rochelle, AU - Younoszai,Abraham, AU - Chandhoke,Vikas, AU - Reines,H David, AU - Goodman,Zachary, AU - Younossi,Zobair M, PY - 2005/4/14/pubmed PY - 2005/7/15/medline PY - 2005/4/14/entrez SP - 310 EP - 5 JF - Obesity surgery JO - Obes Surg VL - 15 IS - 3 N2 - BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a common form of chronic liver disease in the United States. It is commonly associated with the components of the metabolic syndrome including obesity. From the spectrum of NAFLD, only patients with nonalcoholic steatohepatitis (NASH) have been convincingly shown to have a potential for progression to cirrhosis. We report the prevalence of NAFLD and NASH as well as predictors of NASH and advanced fibrosis in morbidly obese patients. METHODS: 212 consecutive patients who underwent bariatric surgery were enrolled in the study. A liver biopsy was performed at the time of the surgery. Causes of chronic liver disease other than NAFLD were excluded by clinical and laboratory evaluation. RESULTS: The prevalence of NAFLD was 93%. Of those with NAFLD, 26% had NASH. 17 patients (9%) had advanced fibrosis (i.e., bridging fibrosis or cirrhosis). Male gender, AST, and type 2 diabetes mellitus were independently associated with NASH. Waistto-hip ratio, AST, and focal hepatocyte necrosis on liver biopsy were independently associated with advanced fibrosis. Interestingly, while AST was associated with NASH and advanced fibrosis, the majority of the patients with either NASH or advanced fibrosis had normal AST. CONCLUSIONS: NAFLD and NASH are very common in morbidly obese patients undergoing bariatric surgery. Features associated with the metabolic syndrome and liver cell injury are independently associated with either NASH or advanced fibrosis. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/15826462/Predictors_of_nonalcoholic_steatohepatitis_and_advanced_fibrosis_in_morbidly_obese_patients_ L2 - https://dx.doi.org/10.1381/0960892053576820 DB - PRIME DP - Unbound Medicine ER -