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Race and comorbid factors predict nonalcoholic fatty liver disease histopathology in severely obese patients.
Surg Obes Relat Dis. 2005 Jan-Feb; 1(1):6-11.SO

Abstract

PURPOSE

Nonalcoholic fatty liver disease (NAFLD) is a common and potentially serious form of chronic liver disease. Although NAFLD is known to be associated with obesity and some comorbid conditions, less is known about the severity of NAFLD among different racial groups.

METHODS

We prospectively studied 237 consecutive morbidly obese patients presenting for bariatric surgery. All patients underwent intraoperative liver biopsy and chart review. After excluding subjects who reported alcohol use (n = 37) or who had missing biopsy data (n = 11), 189 patients were available for analysis. Clinical and laboratory associations with each of the histological components of NAFLD were assessed using multiple logistic regression analysis.

RESULTS

The mean age was 43.1 years, 84% were female, and 13% were African American. It was found that 88% had steatosis, including 35% with moderate to severe steatosis (> 33% of hepatocytes involved). Of these patients, 67% had inflammation, 46% had fibrosis, and 45% met Brunt's criteria for NASH. Compared with Caucasians and after adjustment, African Americans had significantly lower odds of severe hepatic pathology, with adjusted odds ratios of 0.1 (P = .02) for the presence of moderate or severe steatosis, 0.2 for inflammation (P = .006), 0.3 for fibrosis (P = .05), and 0.2 for NASH (P = .02). In addition, participants with one or more features of the metabolic syndrome (ie, diabetes, hypertension, or dyslipidemia) or elevated aminotransferase levels had significantly higher odds of severe hepatic histopathology.

CONCLUSION

Among obese patients presenting for bariatric surgery, NAFLD is more common in Caucasians, patients with features of the metabolic syndrome, and those with elevated aminotransferase levels.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, The Johns Hopkins University, Baltimore, Maryland 21205, USA. solga@jhmi.eduNo 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

16925194

Citation

Solga, Steven F., et al. "Race and Comorbid Factors Predict Nonalcoholic Fatty Liver Disease Histopathology in Severely Obese Patients." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 1, no. 1, 2005, pp. 6-11.
Solga SF, Clark JM, Alkhuraishi AR, et al. Race and comorbid factors predict nonalcoholic fatty liver disease histopathology in severely obese patients. Surg Obes Relat Dis. 2005;1(1):6-11.
Solga, S. F., Clark, J. M., Alkhuraishi, A. R., Torbenson, M., Tabesh, A., Schweitzer, M., Diehl, A. M., & Magnuson, T. H. (2005). Race and comorbid factors predict nonalcoholic fatty liver disease histopathology in severely obese patients. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 1(1), 6-11.
Solga SF, et al. Race and Comorbid Factors Predict Nonalcoholic Fatty Liver Disease Histopathology in Severely Obese Patients. Surg Obes Relat Dis. 2005 Jan-Feb;1(1):6-11. PubMed PMID: 16925194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Race and comorbid factors predict nonalcoholic fatty liver disease histopathology in severely obese patients. AU - Solga,Steven F, AU - Clark,Jeanne M, AU - Alkhuraishi,Amir R, AU - Torbenson,Michael, AU - Tabesh,Alireza, AU - Schweitzer,Michael, AU - Diehl,Anna Mae, AU - Magnuson,Thomas H, PY - 2004/09/22/received PY - 2004/12/07/revised PY - 2004/12/07/accepted PY - 2006/8/24/pubmed PY - 2006/9/29/medline PY - 2006/8/24/entrez SP - 6 EP - 11 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 1 IS - 1 N2 - PURPOSE: Nonalcoholic fatty liver disease (NAFLD) is a common and potentially serious form of chronic liver disease. Although NAFLD is known to be associated with obesity and some comorbid conditions, less is known about the severity of NAFLD among different racial groups. METHODS: We prospectively studied 237 consecutive morbidly obese patients presenting for bariatric surgery. All patients underwent intraoperative liver biopsy and chart review. After excluding subjects who reported alcohol use (n = 37) or who had missing biopsy data (n = 11), 189 patients were available for analysis. Clinical and laboratory associations with each of the histological components of NAFLD were assessed using multiple logistic regression analysis. RESULTS: The mean age was 43.1 years, 84% were female, and 13% were African American. It was found that 88% had steatosis, including 35% with moderate to severe steatosis (> 33% of hepatocytes involved). Of these patients, 67% had inflammation, 46% had fibrosis, and 45% met Brunt's criteria for NASH. Compared with Caucasians and after adjustment, African Americans had significantly lower odds of severe hepatic pathology, with adjusted odds ratios of 0.1 (P = .02) for the presence of moderate or severe steatosis, 0.2 for inflammation (P = .006), 0.3 for fibrosis (P = .05), and 0.2 for NASH (P = .02). In addition, participants with one or more features of the metabolic syndrome (ie, diabetes, hypertension, or dyslipidemia) or elevated aminotransferase levels had significantly higher odds of severe hepatic histopathology. CONCLUSION: Among obese patients presenting for bariatric surgery, NAFLD is more common in Caucasians, patients with features of the metabolic syndrome, and those with elevated aminotransferase levels. SN - 1550-7289 UR - https://www.unboundmedicine.com/medline/citation/16925194/Race_and_comorbid_factors_predict_nonalcoholic_fatty_liver_disease_histopathology_in_severely_obese_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(04)00008-5 DB - PRIME DP - Unbound Medicine ER -