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Predictors of nonalcoholic steatohepatitis (NASH) in obese patients undergoing gastric bypass.
Obes Surg 2005; 15(8):1148-53OS

Abstract

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.

Authors+Show Affiliations

Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile.No affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

16197788

Citation

Boza, Camilo, et al. "Predictors of Nonalcoholic Steatohepatitis (NASH) in Obese Patients Undergoing Gastric Bypass." Obesity Surgery, vol. 15, no. 8, 2005, pp. 1148-53.
Boza C, Riquelme A, Ibañez L, et al. Predictors of nonalcoholic steatohepatitis (NASH) in obese patients undergoing gastric bypass. Obes Surg. 2005;15(8):1148-53.
Boza, C., Riquelme, A., Ibañez, L., Duarte, I., Norero, E., Viviani, P., ... Arrese, M. (2005). Predictors of nonalcoholic steatohepatitis (NASH) in obese patients undergoing gastric bypass. Obesity Surgery, 15(8), pp. 1148-53.
Boza C, et al. Predictors of Nonalcoholic Steatohepatitis (NASH) in Obese Patients Undergoing Gastric Bypass. Obes Surg. 2005;15(8):1148-53. PubMed PMID: 16197788.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of nonalcoholic steatohepatitis (NASH) in obese patients undergoing gastric bypass. AU - Boza,Camilo, AU - Riquelme,Arnoldo, AU - Ibañez,Luis, AU - Duarte,Ignacio, AU - Norero,Enrique, AU - Viviani,Paola, AU - Soza,Alejandro, AU - Fernandez,Jose Ignacio, AU - Raddatz,Alejandro, AU - Guzman,Sergio, AU - Arrese,Marco, PY - 2005/10/4/pubmed PY - 2005/12/24/medline PY - 2005/10/4/entrez SP - 1148 EP - 53 JF - Obesity surgery JO - Obes Surg VL - 15 IS - 8 N2 - 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. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/16197788/Predictors_of_nonalcoholic_steatohepatitis__NASH__in_obese_patients_undergoing_gastric_bypass_ L2 - https://dx.doi.org/10.1381/0960892055002347 DB - PRIME DP - Unbound Medicine ER -