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Prevalence of biopsy-proven non-alcoholic fatty liver disease in severely obese subjects without metabolic syndrome.
Clin Obes 2016; 6(2):117-23CO

Abstract

Obesity is a major risk factor for non-alcoholic fatty liver disease (NAFLD). NAFLD encompasses simple fatty liver (FL) and non-alcoholic steatohepatitis (NASH) in its spectrum. NASH can progress to liver cirrhosis and is associated with liver cancer. Not all obese subjects have insulin resistance (IR) or develop metabolic syndrome (MS). This study evaluates the prevalence of NAFLD in severely obese subjects without MS. We retrospectively reviewed 445 charts from our database of severely obese subjects with clinical suspicion of NAFLD and who were selected for laparoscopic Roux-en-Y gastric bypass surgery. One hundred five subjects who did not have MS, as defined by the International Diabetes Foundation, based on comprehensive pre-operative metabolic evaluation were included. Liver biopsy specimens were evaluated for NAFLD. 24% of morbidly obese (mean body mass index [BMI] 48 kg m(-2)) adult subjects (mean age 38 years) who underwent bariatric surgery did not have MS. NAFLD was identified in 77 (73%) on liver biopsy, out of which 59 (56%) were labelled as FL and 18 (17%) had histological diagnosis of NASH. Age, gender, race and BMI were the same among all groups. Among NAFLD subjects, 22% did not have any additional metabolic component of MS, while 36% had low high-density lipoprotein, 27% had hypertension, 8% had high triglycerides and 6% had hyperglycaemia. IR calculated by HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) and diagnosis of hyperglycaemia was statistically higher in NASH group compared to those who did not have NASH. NAFLD is highly prevalent in morbidly obese individuals who undergo bariatric surgery despite the absence of MS. Diagnosis of hyperglycaemia in such subjects suggests the presence of IR and may have underlying NASH, which is a progressive form of NAFLD.

Authors+Show Affiliations

Section of Gastroenterology and Hepatology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA.Gastroenterology & Liver Center, Greenville Health System, Greenville, SC, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26856683

Citation

Qureshi, K, and G A. Abrams. "Prevalence of Biopsy-proven Non-alcoholic Fatty Liver Disease in Severely Obese Subjects Without Metabolic Syndrome." Clinical Obesity, vol. 6, no. 2, 2016, pp. 117-23.
Qureshi K, Abrams GA. Prevalence of biopsy-proven non-alcoholic fatty liver disease in severely obese subjects without metabolic syndrome. Clin Obes. 2016;6(2):117-23.
Qureshi, K., & Abrams, G. A. (2016). Prevalence of biopsy-proven non-alcoholic fatty liver disease in severely obese subjects without metabolic syndrome. Clinical Obesity, 6(2), pp. 117-23. doi:10.1111/cob.12132.
Qureshi K, Abrams GA. Prevalence of Biopsy-proven Non-alcoholic Fatty Liver Disease in Severely Obese Subjects Without Metabolic Syndrome. Clin Obes. 2016;6(2):117-23. PubMed PMID: 26856683.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of biopsy-proven non-alcoholic fatty liver disease in severely obese subjects without metabolic syndrome. AU - Qureshi,K, AU - Abrams,G A, Y1 - 2016/02/08/ PY - 2015/07/10/received PY - 2015/10/26/revised PY - 2015/11/24/accepted PY - 2016/2/10/entrez PY - 2016/2/10/pubmed PY - 2016/11/10/medline KW - Metabolic syndrome KW - non-alcoholic fatty liver disease KW - obesity SP - 117 EP - 23 JF - Clinical obesity JO - Clin Obes VL - 6 IS - 2 N2 - Obesity is a major risk factor for non-alcoholic fatty liver disease (NAFLD). NAFLD encompasses simple fatty liver (FL) and non-alcoholic steatohepatitis (NASH) in its spectrum. NASH can progress to liver cirrhosis and is associated with liver cancer. Not all obese subjects have insulin resistance (IR) or develop metabolic syndrome (MS). This study evaluates the prevalence of NAFLD in severely obese subjects without MS. We retrospectively reviewed 445 charts from our database of severely obese subjects with clinical suspicion of NAFLD and who were selected for laparoscopic Roux-en-Y gastric bypass surgery. One hundred five subjects who did not have MS, as defined by the International Diabetes Foundation, based on comprehensive pre-operative metabolic evaluation were included. Liver biopsy specimens were evaluated for NAFLD. 24% of morbidly obese (mean body mass index [BMI] 48 kg m(-2)) adult subjects (mean age 38 years) who underwent bariatric surgery did not have MS. NAFLD was identified in 77 (73%) on liver biopsy, out of which 59 (56%) were labelled as FL and 18 (17%) had histological diagnosis of NASH. Age, gender, race and BMI were the same among all groups. Among NAFLD subjects, 22% did not have any additional metabolic component of MS, while 36% had low high-density lipoprotein, 27% had hypertension, 8% had high triglycerides and 6% had hyperglycaemia. IR calculated by HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) and diagnosis of hyperglycaemia was statistically higher in NASH group compared to those who did not have NASH. NAFLD is highly prevalent in morbidly obese individuals who undergo bariatric surgery despite the absence of MS. Diagnosis of hyperglycaemia in such subjects suggests the presence of IR and may have underlying NASH, which is a progressive form of NAFLD. SN - 1758-8111 UR - https://www.unboundmedicine.com/medline/citation/26856683/Prevalence_of_biopsy_proven_non_alcoholic_fatty_liver_disease_in_severely_obese_subjects_without_metabolic_syndrome_ L2 - https://doi.org/10.1111/cob.12132 DB - PRIME DP - Unbound Medicine ER -