[Obesity: risk factor for steatohepatitis and hepatic fibrosis].
BACKGROUND
Nonalcoholic fatty liver (NAFL) has been recognized as a cause of chronic liver disease. Its main risk factor is obesity.


OBJECTIVE
To describe the clinical and liver pathological findings in a group of patients who underwent surgery as obesity treatment.


METHODS
Sixty eight patients with severe or morbid obesity were subjected to surgery as obesity treatment. Each patient was evaluated with a complete clinical and laboratory medical assessment. A wedge of liver was excised during surgery. Liver biopsies were analyzed without knowledge of clinical and laboratory findings. The presence of steatosis, inflammation (portal or lobular), fibrosis and cirrhosis were recorded in the pathological analysis. Age and body mass index (BMI) were correlated with pathological data. Significance was set at a p value of less than 0.05.


RESULTS
Ninety one percent of patients had steatosis, 45% inflammation and 47% fibrosis. One patient had cirrhosis (1.4%). There was a statistically significant association between BMI and moderate or severe steatosis (p < 0.03). There was also an association between BMI and portal (p = 0.017) and lobular inflammation (p = 0.034). A BMI over 40 kg/m2 (morbid obesity) was significantly associated with the presence of fibrosis (p = 0.032). Moreover, the presence of moderate or severe steatosis was a risk factor for the development of hepatic fibrosis (p = 0.026).


CONCLUSIONS
Obesity is a major and independent risk factor for steatohepatitis and fibrosis. The degree of steatosis in the liver biopsy, is a risk factor for the development of fibrosis.
Poniachik
Jaime
J
Centro de Gastroenterología, Departamento de Medicina, Hospital Clínico Universidad de Chile. jponiach@ns.hospital.uchile.cl
Mancilla
Carla
C
Contreras
Jorge
J
Csendes
Attila
A
Smok
Gladys
G
Cavada
Gabriel
G
Rojas
Jorge
J
Oksenberg
Danny
D
Burdiles
Patricio
P
Maluenda
Fernando
F
Díaz
Juan Carlos
JC
D000293:Adolescent; D000328:Adult; D005234:Fatty Liver / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000473:pathology / Q000601:surgery; D012307:Risk Factors