title: [Obesity: risk factor for steatohepatitis and hepatic fibrosis].
abstract: 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.
authors.affiliation: Centro de Gastroenterología, Departamento de Medicina, Hospital Clínico Universidad de Chile. jponiach@ns.hospital.uchile.cl
authors.forename: Jaime
authors.initials: J
authors.lastname: Poniachik
authors.forename: Carla
authors.initials: C
authors.lastname: Mancilla
authors.forename: Jorge
authors.initials: J
authors.lastname: Contreras
authors.forename: Attila
authors.initials: A
authors.lastname: Csendes
authors.forename: Gladys
authors.initials: G
authors.lastname: Smok
authors.forename: Gabriel
authors.initials: G
authors.lastname: Cavada
authors.forename: Jorge
authors.initials: J
authors.lastname: Rojas
authors.forename: Danny
authors.initials: D
authors.lastname: Oksenberg
authors.forename: Patricio
authors.initials: P
authors.lastname: Burdiles
authors.forename: Fernando
authors.initials: F
authors.lastname: Maluenda
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Díaz
mesh_terms: 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