Prevalence of non-alcoholic steatohepatitis in morbidly obese subjects undergoing gastric bypass.
BACKGROUND
Obesity is the most common cause of non-alcoholic steatohepatitis (NASH). This is a prospective study to determine the incidence and severity of NASH in patients undergoing Roux-en-Y gastric bypass (RYGBP) for morbid obesity. We also examined the relationship between NASH and potential risk factors.


METHODS
In 48 consecutive patients at RYGBP, a core liver biopsy was obtained from the left lateral segment. A single liver pathologist reviewed the histology for steatosis, ballooning/disarray, necroinflammation, and fibrosis.


RESULTS
84% of patients were female, and average BMI was 51. 18% had WHR >1. The following risk factors were present: DM 16%; hyperlipidemia 61%; HTN 47%; and abnormal LFTs 18%. 90% had abnormal liver histology, and 56% qualified for the diagnosis of NASH. Only DM and abnormal LFTs were found to be significantly related to NASH.


CONCLUSIONS
NASH is a common co-morbidity of obesity and requires systemized grading and staging to develop accurate knowledge of the incidence, severity, natural history and impact of weight loss.
Spaulding
Laurie
L
Department of Surgery, Fletcher Allen Health Care/University of Vermont College of Medicine, Burlington, USA. Laurie.Spaulding@VTmednet.org
Trainer
Thomas
T
Janiec
Dorota
D
D017677:Age Distribution; D000713:Anastomosis, Roux-en-Y; D001707:Biopsy, Needle; D015897:Comorbidity; D005234:Fatty Liver / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery*; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D017678:Sex Distribution