Predictors of Nonalcoholic Steatohepatitis (NASH) in Obese Patients Undergoing Gastric Bypass (original) (raw)

Background: Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are conditions gaining increasing recognition in hepatology as a potential cause of cirrhosis and end-stage liver disease. Obesity is one of the main risk factors. The aims of this study were to determine the frequency of NAFLD in obese patients and to identify variables that predict NASH. Methods: A prospective study was conducted of obese patients undergoing gastric bypass over a 20-month period. Assessment included liver function tests and evaluation of insulin resistance with the homeostatic model assessment (HOMA-IR). Liver biopsy was performed in all patients at the time of surgery. Clinical and biochemical variables were analyzed using a multivariate analysis to identify independent predictors of NASH. Results: 127 consecutive patients were included (62% female, 38% male, mean age 40±11 years, mean body mass index 42±6 kg/m2). Arterial hypertension was present in 52 patients (41%) and type 2 diabetes in 18 (14%). NAFLD was confirmed in 80 patients (63%), 47 (37%) had simple steatosis, and 33 (26%) had NASH. Cirrhosis was found in 2 patients corresponding to 1.6% of the total population. On multivariate analysis, AST >31 (IU/L) (OR 3.38, CI 1.17-9.8) and HOMA-IR >5.8 (OR 4.18, CI 1.39-12.49) independently predicted NASH. Conclusions: NAFLD is highly prevalent in morbidly obese patients. A high proportion of these patients exhibit NASH on histological examination. Insulin resistance represents the main predictor of NASH.

Access this article

Log in via an institution

Subscribe and save

• Starting from 10 chapters or articles per month
• Access and download chapters and articles from more than 300k books and 2,500 journals
• Cancel anytime View plans

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Author information

Authors and Affiliations

1. Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
   Camilo Boza MD
2. Department of Gastroenterology, Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
   Arnoldo Riquelme MD
3. Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
   Luis Ibañez MD
4. Department of Pathology, Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
   Ignacio Duarte MD
5. Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
   Enrique Norero MD
6. Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
   Paola Viviani MD
7. Department of Gastroenterology, Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
   Alejandro Soza MD
8. Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
   Jose Ignacio Fernandez MD
9. Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
   Alejandro Raddatz MD
10. Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
    Sergio Guzman MD
11. Department of Gastroenterology, Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
    Marco Arrese MD

Authors

1. Camilo Boza MD
2. Arnoldo Riquelme MD
3. Luis Ibañez MD
4. Ignacio Duarte MD
5. Enrique Norero MD
6. Paola Viviani MD
7. Alejandro Soza MD
8. Jose Ignacio Fernandez MD
9. Alejandro Raddatz MD
10. Sergio Guzman MD
11. Marco Arrese MD

Rights and permissions

About this article

Cite this article

Boza, C., Riquelme, A., Ibañez, L. et al. Predictors of Nonalcoholic Steatohepatitis (NASH) in Obese Patients Undergoing Gastric Bypass.OBES SURG 15, 1148–1153 (2005). https://doi.org/10.1381/0960892055002347

Download citation

• Published: 01 September 2005
• Issue date: September 2005
• DOI: https://doi.org/10.1381/0960892055002347