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Erschienen in: Obesity Surgery 12/2015

01.12.2015 | Original Contributions

Utility of Ultrasound, Transaminases, and Visual Inspection to Assess Nonalcoholic Fatty Liver Disease in Bariatric Surgery Patients

verfasst von: Anthony Petrick, Peter Benotti, G. Craig Wood, Christopher D. Still, William E. Strodel, John Gabrielsen, David Rolston, Xin Chu, George Argyropoulos, Anna Ibele, Glenn S. Gerhard

Erschienen in: Obesity Surgery | Ausgabe 12/2015

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Abstract

Background

Nonalcoholic fatty liver disease (NAFLD) is common in adults with extreme obesity and can impact long-term health and survival. Liver biopsy is the only accurate test for diagnosis and staging, but is invasive and costly. Non-invasive testing offers an attractive alternate, but the overall accuracy remains a significant issue. This study was conducted to determine the accuracy and clinical utility of pre-operative ultrasound and liver transaminase levels, as well as intra-operative hepatic visual inspection, for assessing presence of NAFLD as confirmed by hepatic histology.

Methods

Data was collected prospectively from 580 morbidly obese adult patients who underwent Roux-en-Y gastric bypass surgery with intraoperative wedge biopsy between January 2004 and February 2009. Complete data for ultrasound, ALT and AST levels, and documented visual inspection was available for 513 patients.

Results

The prevalence of NAFLD was 69 % and that of NASH was 32 %. The individual non-invasive clinical assessments demonstrated low sensitivity, specificity, and accuracy for detecting the presence of steatosis, steatohepatitis, or fibrosis. The combination of normal or abnormal results for all tests improved predictive utility. Abnormal tests with all three assessments had a sensitivity of 95–98 % and a specificity of 28–48 % for major histologic findings in NAFLD/NASH. Normal tests with all three assessments had a sensitivity of 12–22 % and a specificity of 89–97 % for major histologic findings in NAFLD/NASH.

Conclusions

Although individual clinical tests for NAFLD have limited accuracy, the use of combined clinical tests may prove useful.
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Metadaten
Titel
Utility of Ultrasound, Transaminases, and Visual Inspection to Assess Nonalcoholic Fatty Liver Disease in Bariatric Surgery Patients
verfasst von
Anthony Petrick
Peter Benotti
G. Craig Wood
Christopher D. Still
William E. Strodel
John Gabrielsen
David Rolston
Xin Chu
George Argyropoulos
Anna Ibele
Glenn S. Gerhard
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 12/2015
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1707-6

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