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Erschienen in: Obesity Surgery 2/2012

01.02.2012 | Clinical Research

Clinical Predictors of Different Grades of Nonalcoholic Fatty Liver Disease

verfasst von: Wilson Salgado Júnior, Carla Barbosa Nonino-Borges

Erschienen in: Obesity Surgery | Ausgabe 2/2012

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Abstract

Background

Nonalcoholic fatty liver disease (NAFLD) is one of the comorbidities related to obesity. Liver biopsy has been used as the “gold standard” for the diagnosis, grading, and prognosis of obese patients. The objective of the present study was to evaluate clinical predictors of more advanced stages of NAFLD.

Methods

In this retrospective study we assessed several physical and laboratorial factors, including some cytokines, in morbidly obese patients submitted to Roux-en-Y gastric bypass that could be related to the diagnosis and staging of NAFLD. Fragments of the livers were obtained from wedge biopsies during operation.

Results

The medical records of 259 patients were studied. The patients were divided into four groups: normal hepatic biopsy, steatosis, mild nonalcoholic steatohepatitis (NASH), and moderate and severe NASH. There were no differences in cytokine levels among groups. The triglyceride levels were the only variable that could stratify the grades of NAFLD and also differentiate from normal livers in the female patients. Also in this group, the aminotransferases and GGT levels and fasting glucose were predictors of the more advanced stages of NASH, while BMI and weight were predictors of the more advanced stages of NASH in male patients.

Conclusions

There are no available markers in clinical practice to detect the initial stages of NAFLD. It is very important to perform a liver biopsy in all patients submitted to bariatric surgery and in obese patients with no indication to be operated in the presence of elevated blood levels of aminotransferases, GGT, and fasting glucose.
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Metadaten
Titel
Clinical Predictors of Different Grades of Nonalcoholic Fatty Liver Disease
verfasst von
Wilson Salgado Júnior
Carla Barbosa Nonino-Borges
Publikationsdatum
01.02.2012
Verlag
Springer-Verlag
Erschienen in
Obesity Surgery / Ausgabe 2/2012
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-011-0438-6

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