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Obesity Surgery
Published in: Obesity Surgery 4/2020

01-04-2020 | Fatty Liver | Original Contributions

Fibroscan-Based Score to Predict Significant Liver Fibrosis in Morbidly Obese Patients with Nonalcoholic Fatty Liver Disease

Authors: Wei-Yu Kao, I-Wei Chang, Chi-Long Chen, Chien-Wei Su, Sheng Uei Fang, Jui-Hsiang Tang, Chun-Chao Chang, Yu-Jia Chang, Weu Wang

Published in: Obesity Surgery | Issue 4/2020

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Abstract

Background

The prevalence rate of nonalcoholic fatty liver disease (NAFLD) has been reported in 74 to 90% of morbidly obese patients. This study aims to develop a scoring system that predicts significant liver fibrosis in morbidly obese patients.

Methods

This prospective cohort study involved 123 morbidly obese patients who underwent metabolic surgery at Taipei Medical University Hospital between October 2016 and June 2018. Wedge liver biopsy was performed during surgery, and significant liver fibrosis was defined as a fibrosis score ≧ 2. Ultrasonography and transient elastography were performed prior to surgery to assess the risk factors associated with significant liver fibrosis.

Results

Mean patient age was 35.5 years, mean body mass index (BMI) was 40.6 kg/m2, and 87 (70.7%) were female. Fibrosis staging revealed 28 (22.8%) at stage 2, 14 (11.4%) at stage 3, and 2 (1.6%) at stage 4. Patients were then separated into training (n = 73) and validation (n = 50) cohorts. Multivariate analysis revealed a liver stiffness measurement (LSM) > 7 kPa and aspartate aminotransferase/platelet ratio index (APRI) > 0.40 as independent factors associated with significant liver fibrosis among the training cohort. Fibroscan-base score weighted sum of (1 for presence of APRI > 0.40) + (2 for presence of LSM > 7 kPa) yielded the highest area under receiver operating curve (0.854, P = 0.0001; 0.785, P = 0.0002) compared with other non-invasive markers in the training and validation cohorts, respectively.

Conclusion

We developed a simple, clinical scoring system incorporating Fibroscan and APRI to predict significant liver fibrosis in morbidly obese patients.
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Metadata
Title
Fibroscan-Based Score to Predict Significant Liver Fibrosis in Morbidly Obese Patients with Nonalcoholic Fatty Liver Disease
Authors
Wei-Yu Kao
I-Wei Chang
Chi-Long Chen
Chien-Wei Su
Sheng Uei Fang
Jui-Hsiang Tang
Chun-Chao Chang
Yu-Jia Chang
Weu Wang
Publication date
01-04-2020
Publisher
Springer US
Keyword
Fatty Liver
Published in
Obesity Surgery / Issue 4/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04192-w

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