The spectrum of non alcoholic fatty liver disease in morbidly obese patients: prevalence and associate risk factors

Abstract

PURPOSE:To determine the prevalence of non alcoholic fatty liver disease (NAFLD) and non alcoholic steatohepatitis (NASH) in morbidly obese patients undergoing bariatric surgery and to identify risk factors associated with the disease spectrum. METHODS:Liver biopsy was performed in 60 patients who underwent bariatric surgery, after other causes of liver disease were excluded. Clinical, biochemical and histological features were evaluated. RESULTS:NAFLD was detected in fifty-seven patients (95%) of the sample and forty patients (66.7%) of the total sample met the criteria for NASH. Perisinusoidal fibrosis was only found in three (7.5%) patients with NASH. The γGT was an independent predictive factor associated with the degree of hepatic steatosis. The variables such as dyslipidemia and ALT were independently associated with the presence of Mallory's corpuscles with the following values, respectively, OR 0, 05, 95% CI 0.002 to 0.75, P = 0.031 and OR 10, 99, 95% CI 1.44 to 83.93, P = 0.021. CONCLUSIONS:Non alcoholic fatty liver disease seems to be an obese-related condition with approximately half of asymptomatic morbidly obese patients having histological NASH. The γGT was an independent predictor of the degree of steatosis.

Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention

“…Although there are estimates for the prevalence of NAFLD in South America, the data on the prevalence of NASH is even more scarce. Nevertheless, in one study, 61% of the morbidly obese patients with NAFLD in South America were found to have NASH, which could make the prevalence of NASH 6-18% 20 . Again, these rates can be influenced by genetic predisposition, as described later.…”

“…Again, these rates can be influenced by genetic predisposition, as described later. In summary, NAFLD prevalence rates differ by ethnicity within the USA 1,[18][19][20][21] . The Hispanic population has the highest prevalence whereas African Americans are reported to have the lowest prevalence, despite hav ing higher prevalence of hypertension and obesity, both NAFLD risk factors.…”

Predictive Factors of Steatosis and Non-Alcoholic Steatohepatitis in Morbidly Obese Patients Undergoing Bariatric Surgery

“…Feijo et al evaluated the prevalence of NAFLD and NASH in patients with morbid obesity undergoing bariatric surgery and identified the risk factors associated with the disease spectrum. They concluded that NAFLD seemed to be an obesityrelated condition and approximately half of the asymptomatic patients with morbid obesity had histological characteristics of NASH (30). According to Helling et al only the increased TG levels and decreased pre-albumin correlated with NASH (31).…”

Steatosis and Insulin Resistance: Prevalence and Association With Cardiovascular Risk in Obese Adolescents

“…The advance in the knowledge of the NAFLD physiopathology has motivated clinical studies with the aim of identifying steatosis with non-invasive markers. Age, obesity, DM2, high blood pressure (HBP), inflammation markers, aspartate aminotrasferase relation (AST)/alanine aminotransferase (ALT) and the increased levels of triglycerides (TG) are pointed out as risk factors for the presence of steatosis [17]. Of all these factors, obesity and IR were most consistently connected with liver steatosis.…”