The Prevalence of NAFLD and Fibrosis in Bariatric Surgery Patients and the Reliability of Noninvasive Diagnostic Methods
Joint Authors
Cervello, Melchiorre
Cabibi, Daniela
Porcasi, Rossana
Soresi, Maurizio
Giannitrapani, Lydia
Montalto, Giuseppe
Giglio, Rosaria V.
Martorana, Stefania
Guercio, Giuseppina
Terranova, Antonino
Lazzaro, Luigi A.
Emma, Maria R.
Augello, Giuseppa
Pantuso, Gianni
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-04-27
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background.
Bariatric surgery patients have a higher prevalence of nonalcoholic fatty liver (NAFL) than the general population; however, its assessment and the accurate staging of fibrosis are often complicated because noninvasive tests are not very accurate in patients with morbid obesity, and liver biopsy cannot be performed as a routine exam.
The aim of this study was to evaluate (A) the histological prevalence of NAFL, nonalcoholic steatohepatitis (NASH), and fibrosis in patients undergoing bariatric surgery; (B) the reliability of ultrasound (US) in diagnosing NAFL; and (C) the reliability of various fibrosis scoring systems for defining fibrosis.
Methods.
US and intraoperative liver biopsy results were reviewed in 57 bariatric surgery patients.
NAFL, NASH, and fibrosis were diagnosed according to the Kleiner scoring system.
US diagnosis of liver steatosis was based on the bright liver.
Fibrosis scores used were (i) the BMI, AST/ALT Ratio, Diabetes (BARD) scoring system; (ii) the nonalcoholic fatty liver disease (NAFLD) fibrosis score; and (iii) the fibrosis-4 (FIB-4) index.
Results.
The prevalence of NAFL was 81%, NASH 61.4%, and fibrosis 94% (F3 5.7%, cirrhosis 2.8%).
The sensitivity of US was 95%, specificity 50%, and likelihood ratio (LR+, LR-) 1.91 and 0.1.
The reliability of fibrosis scores for F≥2 were as follows: BARD score: sensitivity 46%, specificity 54%, and area under the receiver-operating characteristics (AUROC) curve 0.5; NAFLD score: sensitivity 30%, specificity 89%, and AUROC 0.5; and FIB-4: sensitivity 68%, specificity 67%, and AUROC 0.7.
Conclusions.
In bariatric surgery patients, the prevalence of NAFL was 81%, NASH 61.4%, and fibrosis 94%.
US is able to rule out the presence of NAFL, while the commonly used scores may be inaccurate in defining fibrosis in patients with morbid obesity.
American Psychological Association (APA)
Soresi, Maurizio& Cabibi, Daniela& Giglio, Rosaria V.& Martorana, Stefania& Guercio, Giuseppina& Porcasi, Rossana…[et al.]. 2020. The Prevalence of NAFLD and Fibrosis in Bariatric Surgery Patients and the Reliability of Noninvasive Diagnostic Methods. BioMed Research International،Vol. 2020, no. 2020, pp.1-7.
https://search.emarefa.net/detail/BIM-1134372
Modern Language Association (MLA)
Soresi, Maurizio…[et al.]. The Prevalence of NAFLD and Fibrosis in Bariatric Surgery Patients and the Reliability of Noninvasive Diagnostic Methods. BioMed Research International No. 2020 (2020), pp.1-7.
https://search.emarefa.net/detail/BIM-1134372
American Medical Association (AMA)
Soresi, Maurizio& Cabibi, Daniela& Giglio, Rosaria V.& Martorana, Stefania& Guercio, Giuseppina& Porcasi, Rossana…[et al.]. The Prevalence of NAFLD and Fibrosis in Bariatric Surgery Patients and the Reliability of Noninvasive Diagnostic Methods. BioMed Research International. 2020. Vol. 2020, no. 2020, pp.1-7.
https://search.emarefa.net/detail/BIM-1134372
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1134372