[Relationship between morphological diagnosis of NASH (non-alcoholic steatohepatitis) and liver function tests in a group of patients with morbid obesity].
The non-alcoholic steato-hepatitis (NASH) is a common disorder in obese, type 2 diabetics, female and patients with dislipidaemia. Hepatic biochemical test are abnormal. Despite the lack of its own morphological characteristics, NASH can be differentiated from other pathologies, the gold standard for diagnosis is liver biopsy.


METHODS
We designed a retrolective, comparative, observational and cross-sectional study. Thirty-five obese subjects (11 men and 24 women) who underwent to bariatric surgery and liuer biopsy were included. Data were taken from clinical files, such as anthropometric and biochemical test. Those who had clinical history of related alcohol ingestion or liver damage related to drugs were excluded. A experimented pathologist classified the biopsies according to Brunt classification. Liver slides were classified according to 1) presence of NASH; 2) Inflammation and 3) Fibrosis. Differences between groups were analysed by ANOVA and Spearman correlation.


RESULTS
We found differences between women (w) and men (m) for height (m: 1.71 +/- 0.9 vs. w:1.60 +/- 0.09m); weight (m:172.5 +/- 39.1 vs. w:126.9 +/- 24.1kg) and BMI (m:58.2 +/- 9.8 vs. w:49.8 +/- 9) , but not for NASH frequency. Nevertheless subjects with NASH (n = 29, 82.8%o) were older than those without NASH (38.3 +/- 9.6 vs. 29.5 +/- 5.2) and had higher aminotrasferases serum levels (AST: 33.1 +/- 19.2 vs. 23.7 +/- 6.3 ULIL; ALT: 36.5 +/- 19.8 vs. 20.3 +/- 7.6ULIL). NASH pa- tients and those with higher grade of histological inflammation had increment of transaminases and albumin levels. Fibrosis showed correlation only with AST (p = 0.020) and ALT (p = 0.002).


CONCLUSIONS
The NASH frequency in patients who underwent to bariatric surgery for weight reduction is very high (82.8%) and exists correlation among liver test and histological findings but not with clinical because the clinical diagnosis is complicated.
Chavarría-Arciniega
Sonia
S
Clínica de Obesidad del Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.
López-Alvarenga
Juan Carlos
JC
Uribe-Uribe
Norma Ofelia
NO
Herrera-Hernández
Miguel
M
González-Barranco
Jorge
J
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D050110:Bariatric Surgery; D001706:Biopsy; D001827:Body Height; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005227:Fatty Acids / Q000097:blood; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D005260:Female; D006505:Hepatitis / Q000209:etiology / Q000473:pathology; D006801:Humans; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D015995:Prevalence; D012189:Retrospective Studies
D005227:Fatty Acids; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase