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01.03.2020 | Original Article

Noninvasive assessment of hepatic steatosis and fibrosis in patients with severe obesity

verfasst von: Federica Coccia, Moira Testa, Gloria Guarisco, Enea Bonci, Claudio Di Cristofano, Gianfranco Silecchia, Frida Leonetti, Amalia Gastaldelli, Danila Capoccia

Erschienen in: Endocrine | Ausgabe 3/2020

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Abstract

Purpose

In morbid obesity nonalcoholic fatty liver disease (NAFLD) is endemic. Aim of this study is to evaluate the diagnostic accuracy of the most common noninvasive methods for identify NAFLD and fibrosis in a cohort of morbid obese population.

Methods

Ninety morbid obese patients undergoing bariatric surgery (BS) and intraoperative liver biopsy were evaluated preoperatively with Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and serum biomarkers for steatosis and fibrosis and liver stiffness measurement (LSM) using acoustic radiation force impulse (ARFI) elastography. All nondiabetic patient (n = 77) underwent OGTT and calculation of Oral Glucose Insulin Sensitivity index (OGIS).

Results

In the entire cohort prevalence of NAFLD was 77%, NASH 24%, moderate/severe steatosis 50%, and significant fibrosis 14%. New cut-offs were evaluated for all steatosis score assessed in this population. In all patients with moderate/severe steatosis HOMA IR was significantly greater than 3.5. ALT, GGT, Triglycerides, HOMA IR, and ARFI increased with fibrosis grade (p 0.03, p 0.008, p 0.04, p 0.05, respectively) and AST to Platelet ratio (APRI) was the only noninvasive fibrosis score significantly increased in significant fibrosis (p 0.04). A combination of 1/OGIS and VAI was able to discriminate NASH from simple steatosis (NAFL) (p 0.02).

Conclusions

In morbid obese subjects, we calculated new cut-offs of the most common steatosis indexes and found that a score based on insulin resistance (1/OGIS) and abdominal obesity (VAI) could represent a way to identify morbid obese subjects at risk of NASH.
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Metadaten
Titel
Noninvasive assessment of hepatic steatosis and fibrosis in patients with severe obesity
verfasst von
Federica Coccia
Moira Testa
Gloria Guarisco
Enea Bonci
Claudio Di Cristofano
Gianfranco Silecchia
Frida Leonetti
Amalia Gastaldelli
Danila Capoccia
Publikationsdatum
01.03.2020
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 3/2020
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-019-02155-w

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