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Nonalcoholic Fatty Liver Disease in Morbidly Obese Subjects: Correlation Among Histopathologic Findings, Biochemical Features, and Ultrasound Evaluation

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Abstract

Nonalcoholic fatty liver disease (NAFLD) has become an important health issue lately. The aim of this study is to determine its prevalence among obese subjects which undergo Roux-en-Y gastric bypass (RYGB). It is a cross-sectional retrospective study involving 164 subjects who underwent RYGB. Clinical, biochemical, and histopathologic features were evaluated. The most common histopathologic features observed were steatohepatitis with fibrosis (29.9 %) and isolated fibrosis (29.3 %). Increased alkaline phosphatase was associated to NAFLD. Dyslipidemia and type 2 diabetes mellitus were associated to NAFLD. Ultrasound had a global accuracy of 78 % to detect NAFLD. Higher prevalence of severe forms of NAFLD was observed compared to previous reports. Most routine biochemical studies had poor correlation with NAFLD and ultrasound was useful but not definitive to detect NAFLD.

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References

  1. Gigante DP, de França GV, Sardinha LM, et al. Temporal variation in the prevalence of weight and obesity excess in adults: Brazil, 2006 to 2009. Rev Bras Epidemiol. 2011;14 Suppl 1:157–65.

    Article  PubMed  Google Scholar 

  2. Kuppan G, Anjana RM, Deepa M, et al. Inflammatory markers in relation to nonalcoholic fatty liver disease in urban South Indians. Diabetes Technol Ther. 2012;14(2):152–8.7.

    Article  PubMed  CAS  Google Scholar 

  3. Cusi K. Role of obesity and lipotoxicity in the development of nonalcoholic steatohepatitis: pathophysiology and clinical implications. Gastroenterology. 2012;142(4):711–25.

    Article  PubMed  CAS  Google Scholar 

  4. Fabbrini E, Sullivan S, Klein S. Obesity and nonalcoholic fatty liver disease: biochemical, metabolic and clinical implications. Hepatology. 2010;51(2):679–89.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  5. McCullough AJ. Pathophysiology of nonalcoholic steatohepatitis. J Clin Gastroenterol. 2006;40 suppl 1:S17–29.

    PubMed  CAS  Google Scholar 

  6. Brunt EM. Nonalcoholic steatohepatitis. Semin Liver Dis. 2004;24(1):3–20.

    Article  PubMed  Google Scholar 

  7. Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference statement. Am J Clin Nutr. 1992;55(2 Suppl):615S–9S.

    Google Scholar 

  8. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–19.

    Article  PubMed  CAS  Google Scholar 

  9. Abrams GA, Kunde SS, Lazenby AJ, et al. Portal fibrosis and hepatic steatosis in morbidly obese subjects: a spectrum of nonalcoholic fatty liver disease. Hepatology. 2004;40(2):475–83.

    Article  PubMed  Google Scholar 

  10. Guajardo-Salinas GE, Hilmy A. Prevalence of nonalcoholic fatty liver disease (NAFLD) and utility of FIBROspect II to detect liver fibrosis in morbidly obese Hispano-American patients undergoing gastric bypass. Obes Surg. 2010;20(12):1647–53.

    Article  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. Kashyap SR, Diab DL, Baker AR, et al. Triglyceride levels and not adipokine concentrations are closely related to severity of nonalcoholic fatty liver disease in an obesity surgery cohort. Obesity (Silver Spring). 2009;17(9):1696–701.

    Article  CAS  Google Scholar 

  13. Shalhub S, Parsee A, Gallagher SF, et al. The importance of routine liver biopsy in diagnosing nonalcoholic steatohepatitis in bariatric patients. Obes Surg. 2004;14(1):54–9.

    Article  PubMed  Google Scholar 

  14. Luyckx FH, Desaive C, Thiry A, et al. Liver abnormalities in severely obese subjects: effect of drastic weight loss after gastroplasty. Int J Obes Relat Metab Disord. 1998;22(3):222–6.

    Article  PubMed  CAS  Google Scholar 

  15. De Freitas AC, Campos AC, Coelho JC. The impact of bariatric surgery on nonalcoholic fatty liver disease. Curr Opin Clin Nutr Metab Care. 2008;11(3):267–74.

    Article  PubMed  Google Scholar 

  16. Vargas V, Allende H, Lecube A, et al. Surgically induced weight loss by gastric bypass improves non alcoholic fatty liver disease in morbid obese patients. World J Hepatol. 2012;4(12):382–8.

    PubMed Central  PubMed  Google Scholar 

  17. Clark JM, Alkhuraishi AR, Solga SF, et al. Roux-en-Y gastric bypass improves liver histology in patients with nonalcoholic fatty liver disease. Obes Res. 2005;13(7):1180–6.

    Article  PubMed  Google Scholar 

  18. Wu J, You J, Yerian L, et al. Prevalence of liver steatosis and fibrosis and the diagnostic accuracy of ultrasound in bariatric surgery patients. Obes Surg. 2012;22(2):240–7.

    Article  PubMed  Google Scholar 

  19. Liang RJ, Wang HH, Lee WJ, et al. Diagnostic value of ultrasonographic examination for nonalcoholic steatohepatitis in morbidly obese patients undergoing laparoscopic bariatric surgery. Obes Surg. 2007;17(1):45–56.

    Article  PubMed  Google Scholar 

  20. Grandison GA, Angulo P. Can NASH be diagnosed, graded, and staged noninvasively? Clin Liver Dis. 2012;16(3):567–85.

    Article  PubMed Central  PubMed  Google Scholar 

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The authors have no conflict of interest to disclose.

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Correspondence to Everton Cazzo.

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Cazzo, E., de Felice Gallo, F., Pareja, J.C. et al. Nonalcoholic Fatty Liver Disease in Morbidly Obese Subjects: Correlation Among Histopathologic Findings, Biochemical Features, and Ultrasound Evaluation. OBES SURG 24, 666–668 (2014). https://doi.org/10.1007/s11695-014-1183-4

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  • DOI: https://doi.org/10.1007/s11695-014-1183-4

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