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Published in: Obesity Surgery 4/2014

01-04-2014 | Brief Communication

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

Authors: Everton Cazzo, Fabio de Felice Gallo, José Carlos Pareja, Elinton Adami Chaim

Published in: Obesity Surgery | Issue 4/2014

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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.
Literature
1.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
2.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
3.
go back to reference Cusi K. Role of obesity and lipotoxicity in the development of nonalcoholic steatohepatitis: pathophysiology and clinical implications. Gastroenterology. 2012;142(4):711–25.PubMedCrossRef Cusi K. Role of obesity and lipotoxicity in the development of nonalcoholic steatohepatitis: pathophysiology and clinical implications. Gastroenterology. 2012;142(4):711–25.PubMedCrossRef
4.
go back to reference Fabbrini E, Sullivan S, Klein S. Obesity and nonalcoholic fatty liver disease: biochemical, metabolic and clinical implications. Hepatology. 2010;51(2):679–89.PubMedCentralPubMedCrossRef Fabbrini E, Sullivan S, Klein S. Obesity and nonalcoholic fatty liver disease: biochemical, metabolic and clinical implications. Hepatology. 2010;51(2):679–89.PubMedCentralPubMedCrossRef
5.
go back to reference McCullough AJ. Pathophysiology of nonalcoholic steatohepatitis. J Clin Gastroenterol. 2006;40 suppl 1:S17–29.PubMed McCullough AJ. Pathophysiology of nonalcoholic steatohepatitis. J Clin Gastroenterol. 2006;40 suppl 1:S17–29.PubMed
7.
go back to reference Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference statement. Am J Clin Nutr. 1992;55(2 Suppl):615S–9S. Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference statement. Am J Clin Nutr. 1992;55(2 Suppl):615S–9S.
8.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
9.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
10.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
11.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
12.
go back to reference 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.CrossRef 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.CrossRef
13.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
14.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
15.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
16.
go back to reference 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.PubMedCentralPubMed 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.PubMedCentralPubMed
17.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
18.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
19.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
Metadata
Title
Nonalcoholic Fatty Liver Disease in Morbidly Obese Subjects: Correlation Among Histopathologic Findings, Biochemical Features, and Ultrasound Evaluation
Authors
Everton Cazzo
Fabio de Felice Gallo
José Carlos Pareja
Elinton Adami Chaim
Publication date
01-04-2014
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2014
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1183-4

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