Predictors of Nonalcoholic Steatohepatitis and Advanced Fibrosis in Morbidly Obese Patients

2005 ◽  
Vol 15 (3) ◽  
pp. 310-315 ◽  
Author(s):  
Janus P. Ong ◽  
Hazem Elariny ◽  
Rochelle Collantes ◽  
Abraham Younoszai ◽  
Vikas Chandhoke ◽  
...  
Keyword(s):  
Nonalcoholic Steatohepatitis ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Advanced Fibrosis

S1900 Mitochondrial Complex III Is Decreased in Morbidly Obese Patients with Nonalcoholic Steatohepatitis

2008 ◽  
Vol 134 (4) ◽  
pp. A-780
Author(s):  
Kamran Qureshi ◽  
Michelle S. Johnson ◽  
Ronald H. Clements ◽  
Gary A. Abrams ◽  
Aimee L. Landar
Keyword(s):  
Nonalcoholic Steatohepatitis ◽  
Complex Iii ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Mitochondrial Complex

scholarly journals Active Helicobacter pylori Infection is Independently Associated with Nonalcoholic Steatohepatitis in Morbidly Obese Patients

2020 ◽  
Vol 9 (4) ◽  
pp. 933 ◽  
Author(s):  
Michael Doulberis ◽  
Simone Srivastava ◽  
Stergios A Polyzos ◽  
Jannis Kountouras ◽  
Apostolis Papaefthymiou ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Nonalcoholic Steatohepatitis ◽  
Liver Function Tests ◽  
Gastric Biopsy ◽  
Helicobacter Pylori Infection ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Nonalcoholic Fatty Liver ◽  
Potential Impact ◽  
Lobular Inflammation

Nonalcoholic fatty liver disease (NAFLD) emerges as an important global burden and Helicobacter pylori infection (Hp-I) has been suggested as a risk factor of NAFLD, although controversy exists. This retrospective study aimed to investigate a potential impact of active Hp-I on NAFLD severity in morbidly obese patients, subjected to bariatric surgery and gastric biopsy for documentation of Hp-I. Of 64 eligible participants, 15 (23.4%) were diagnosed with active Hp-I, showing higher rates of nonalcoholic steatohepatitis (NASH) than those without Hp-I (86.7% vs. 26.5%, respectively; p < 0.001). Concerning histological lesions, steatosis grade (p = 0.027), ballooning (p < 0.001), lobular inflammation (p = 0.003), and fibrosis stage (p < 0.001) were also more severe in Hp-I positive patients. Likewise, liver function tests, insulin resistance, dyslipidemia, and arterial hypertension were significantly higher in Hp-I positive patients. Hp-I was independently positively associated with NASH (beta = 3.27; p = 0.002), severe NASH (beta = 2.37; p = 0.018), and the presence of fibrosis (beta = 3.86; p = 0.001) in a binary regression model, after adjustment for potential confounders. In conclusion, active Hp-Ι was independently associated with NASH and fibrosis, findings offering potential clinical implication.

A clinical scoring system for predicting nonalcoholic steatohepatitis in morbidly obese patients

Hepatology ◽  
2008 ◽  
Vol 47 (6) ◽  
pp. 1916-1923 ◽  
Author(s):  
Guilherme M. Campos ◽  
Kiran Bambha ◽  
Eric Vittinghoff ◽  
Charlotte Rabl ◽  
Andrew M. Posselt ◽  
...  
Keyword(s):  
Nonalcoholic Steatohepatitis ◽  
Scoring System ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Clinical Scoring

scholarly journals Parathyroid Hormone Levels May Predict Nonalcoholic Steatohepatitis in Morbidly Obese Patients

2015 ◽  
Vol 15 (7) ◽  
Author(s):  
Morteza Ghoghaei ◽  
Foad Taghdiri ◽  
Elias Khajeh ◽  
Farid Azmoudeh Ardalan ◽  
Mojtaba Sedaghat ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Nonalcoholic Steatohepatitis ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Hormone Levels

Prevalence and Predictors of Nonalcoholic Steatohepatitis in Obese Patients Undergoing Bariatric Surgery: A Department of Defense Experience

2014 ◽  
Vol 80 (6) ◽  
pp. 595-599 ◽  
Author(s):  
Jeffrey L. Reha ◽  
Sukhyung Lee ◽  
Luke J. Hofmann
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Nonalcoholic Steatohepatitis ◽  
Normal Liver ◽  
Multivariate Regression Analysis ◽  
Common Finding ◽  
Systemic Hypertension ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Increased Risk

Nonalcoholic steatohepatitis (NASH) is a silent liver disease that can lead to inflammation and subsequent scaring. If left untreated, cirrhosis may ensue. Morbidly obese patients are at an increased risk of NASH. We report the prevalence and predictors of NASH in patients undergoing morbid obesity surgery. A retrospective review was conducted on morbidly obese patients undergoing weight reduction surgery from September 2005 through December 2008. A liver biopsy was performed at the time of surgery. Patients who had a history of hepatitis infection or previous alcohol dependency were excluded. Prevalence of NASH was studied. Predictors of NASH among clinical and biochemical variables were analyzed using multivariate regression analysis. One hundred thirteen patients were analyzed (84% female; mean age, 42.6 ± 11.4 years; mean body mass index, 45.1 ± 5.7 kg/m2). Sixty-one patients had systemic hypertension (54%) and 35 patients had diabetes (31%). The prevalence of NASH in this study population was 35 per cent (40 of 113). An additional 59 patients (52%) had simple steatosis without NASH. Only 14 patients had normal liver histology. On multivariate analysis, only elevated aspartate aminotransferase (AST) (greater than 41 IU/L) was the independent predictor for NASH (odds ratio, 5.85; confidence interval, 1.06 to 32.41). Patient age, body mass index, hypertension, diabetes, hypercholesterolemia, and abnormal alanine aminotransferase did not predict NASH. NASH is a common finding in obese population. Abnormal AST was the only predictive factor for NASH.

scholarly journals Evaluation of the nonalcoholic fat liver disease fibrosis score for patients undergoing bariatric surgery

2010 ◽  
Vol 47 (2) ◽  
pp. 170-173 ◽  
Author(s):  
Silvania Klug Pimentel ◽  
Rodrigo Strobel ◽  
Carolina Gomes Gonçalves ◽  
Danielle Giacometti Sakamoto ◽  
Flávio Heuta Ivano ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Advanced Fibrosis ◽  
Fibrosis Score ◽  
Advanced Liver Fibrosis ◽  
Fat Liver

CONTEXT: Morbidly obese patients have an increased risk for nonalcoholic fat liver disease. Its severe form, nonalcoholic steatohepatitis may cause liver fibrosis. The diagnosis of advanced fibrosis has great value during the pre operative evaluation for bariatric surgery. Currently, liver biopsy is the gold standard for diagnosis of liver fibrosis. OBJECTIVE: To evaluate the nonalcoholic fat liver disease fibrosis score in morbidly obese patients undergoing Roux-en-Y gastric bypass in our population. METHODS: One hundred fifty-eight morbidly obese patients that had undergone bariatric surgery were included. Age, body mass index, hyperglycemia, platelet count, albumin and AST/ALT ratio were applied to the score formula. Scores above 0.676 were indicative of advanced liver fibrosis and scores under -1,455 absence of advanced liver fibrosis. These scores were compared to liver biopsy findings. RESULTS: The presence of advanced fibrosis could be diagnosed with good accuracy, with a positive predictive value of 83.7%. The score had a higher accuracy to exclude advanced fibrosis with a negative predictive value of 97%. Twenty-five patients (16%) had scores between the cutoffs points and were identified as indeterminate. The score sensibility and specificity was 83% and 97% respectively. CONCLUSIONS: The nonalcoholic fat liver disease fibrosis score has high accuracy to identify and exclude advanced liver fibrosis in morbidly obese patients subjected to bariatric surgery.

scholarly journals Bariatric Surgery Reduces Features of Nonalcoholic Steatohepatitis in Morbidly Obese Patients

2015 ◽  
Vol 149 (2) ◽  
pp. 379-388 ◽  
Author(s):  
Guillaume Lassailly ◽  
Robert Caiazzo ◽  
David Buob ◽  
Marie Pigeyre ◽  
Hélène Verkindt ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Nonalcoholic Steatohepatitis ◽  
Morbidly Obese ◽  
Obese Patients

scholarly journals Performance of Noninvasive Liver Fibrosis Tests in Morbidly Obese Patients with Nonalcoholic Fatty Liver Disease

2021 ◽  
Author(s):  
Saleh A. Alqahtani ◽  
Pegah Golabi ◽  
James M. Paik ◽  
Brian Lam ◽  
Amir H. Moazez ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Advanced Fibrosis ◽  
Predictive Values ◽  
Nonalcoholic Fatty Liver ◽  
Optimal Thresholds

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in morbidly obese patients, and fibrosis is an independent predictor of mortality. Noninvasive tests (NITs) are being developed for the detection of advanced fibrosis (AF). Purpose To assess the performance of three NITs (NAFLD fibrosis score, NFS, fibrosis-4 index, FIB-4, and aspartate aminotransferase-to-platelet ratio, APRI), in the identification of AF among morbidly obese patients. Materials and Methods Patients, who underwent bariatric surgery between 2004 and 2009 and had liver biopsy, were included. Fibrosis stages ≥ F2 and ≥ F3 were defined as significant and AF, respectively. Published and optimal thresholds (Youden index) for NFS, FIB-4 and APRI, sensitivity, specificity, positive and negative predictive values (PPV-NPV), and area under the receiver operator curves (AUROC) were evaluated. Results Among 584 patients (mean age 43.3 ± 11.3 years, 21.2% male, 75% white, mean BMI 45.5 ± 8.80), 31.7% had NASH. Stages distributions were F1 = 68.1%, F2 = 16.4%, F3 = 8%, and F4 = 3.2%. At published thresholds, all 3 NITs performed poorly for detection of AF, with AUROC < 0.62. Overall performance at optimal thresholds improved to 0.68, 0.72, and 0.74 for NFS, FIB-4, and APRI, respectively. At optimal thresholds, all tests had good NPV (94.4–95.9%) but low PPV (24.2–32.5%). Combinations of the tests did not improve their performance. Conclusions NFS, FIB-4, and APRI fall short to detect advanced fibrosis but valuable for excluding advanced fibrosis. More research is needed to develop new NITs with high positive predictive value.

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