Prevalence and predictors of non-alcoholic steatohepatitis in patients with morbid obesity.
Bariatric surgery
Cirugía bariátrica
Esteatohepatitis no alcohólica
Morbid obesity
Non-alcoholic steatohepatitis
Non-invasive predictors
Obesidad mórbida
Predictores no invasivos
Journal
Endocrinologia, diabetes y nutricion
ISSN: 2530-0180
Titre abrégé: Endocrinol Diabetes Nutr (Engl Ed)
Pays: Spain
ID NLM: 101717565
Informations de publication
Date de publication:
30 Jul 2021
30 Jul 2021
Historique:
received:
21
12
2020
revised:
27
03
2021
accepted:
07
04
2021
entrez:
3
8
2021
pubmed:
4
8
2021
medline:
4
8
2021
Statut:
aheadofprint
Résumé
Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in morbid obesity (MO). A considerable proportion of patients with MO have non-alcoholic steatohepatitis (NASH). Liver biopsy (LB) is the only procedure that reliably differentiates NASH from other stages of NAFLD, but its invasive nature prevents it from being generalisable. Hence, non-invasive assessment is critical in this group of patients. To report NAFLD/NASH prevalence in a cohort of patients with MO and to identify predictors of NASH. Fifty-two consecutive patients subjected to bariatric surgery in a University hospital in Spain underwent LB. Anthropometric, clinical and biochemical variables were registered. According of the results of the LB, individuals were classified by whether they had NASH or not. Multiple logistic regression analysis was performed to identify independent factors associated with NASH. NAFLD was reported in 94.2% of the patients, simple steatosis was present in 51.92% and NASH in 42.31%. Meanwhile, 17.3% of patients exhibited significant fibrosis (≥F2). HIGHT score for NASH risk was established using five independent predictors: systemic Hypertension, Insulin resistance, Gamma-glutamyl transferase, High density lipoprotein cholesterol and alanine Transaminase. This score ranges from 0 to 7 and was used to predict NASH in our cohort (area under the receiver operator characteristic curve 0.846). A score of 4 or greater implied high risk (sensitivity 77.3%, specificity 73.3%, positive predictive value 68%, negative predictive value 81.5%, accuracy 75%). NAFLD is practically a constant in MO with a considerable proportion of patients presenting NASH. The combination of five independent predictors in a scoring system may help the clinician optimise the selection of patients with MO for LB.
Sections du résumé
BACKGROUND
BACKGROUND
Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in morbid obesity (MO). A considerable proportion of patients with MO have non-alcoholic steatohepatitis (NASH). Liver biopsy (LB) is the only procedure that reliably differentiates NASH from other stages of NAFLD, but its invasive nature prevents it from being generalisable. Hence, non-invasive assessment is critical in this group of patients.
OBJECTIVES
OBJECTIVE
To report NAFLD/NASH prevalence in a cohort of patients with MO and to identify predictors of NASH.
METHODS
METHODS
Fifty-two consecutive patients subjected to bariatric surgery in a University hospital in Spain underwent LB. Anthropometric, clinical and biochemical variables were registered. According of the results of the LB, individuals were classified by whether they had NASH or not. Multiple logistic regression analysis was performed to identify independent factors associated with NASH.
RESULTS
RESULTS
NAFLD was reported in 94.2% of the patients, simple steatosis was present in 51.92% and NASH in 42.31%. Meanwhile, 17.3% of patients exhibited significant fibrosis (≥F2). HIGHT score for NASH risk was established using five independent predictors: systemic Hypertension, Insulin resistance, Gamma-glutamyl transferase, High density lipoprotein cholesterol and alanine Transaminase. This score ranges from 0 to 7 and was used to predict NASH in our cohort (area under the receiver operator characteristic curve 0.846). A score of 4 or greater implied high risk (sensitivity 77.3%, specificity 73.3%, positive predictive value 68%, negative predictive value 81.5%, accuracy 75%).
CONCLUSIONS
CONCLUSIONS
NAFLD is practically a constant in MO with a considerable proportion of patients presenting NASH. The combination of five independent predictors in a scoring system may help the clinician optimise the selection of patients with MO for LB.
Identifiants
pubmed: 34340957
pii: S2530-0164(21)00180-4
doi: 10.1016/j.endinu.2021.04.007
pii:
doi:
Types de publication
Journal Article
Langues
eng
spa
Informations de copyright
Copyright © 2021 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.