title: Evaluation of the nonalcoholic fat liver disease fibrosis score for patients undergoing bariatric surgery.
abstract: BACKGROUND
  Morbidly obese patients have an increased risk for nonalcoholic fat liver disease. Its severe form, nonalcoholic steatohepatitis may cause liver fibrosis. The diagnosis of advanced fibrosis has great value during the pre operative evaluation for bariatric surgery. Currently, liver biopsy is the gold standard for diagnosis of liver fibrosis.
  
  
  OBJECTIVE
  To evaluate the nonalcoholic fat liver disease fibrosis score in morbidly obese patients undergoing Roux-en-Y gastric bypass in our population.
  
  
  METHODS
  One hundred fifty-eight morbidly obese patients that had undergone bariatric surgery were included. Age, body mass index, hyperglycemia, platelet count, albumin and AST/ALT ratio were applied to the score formula. Scores above 0.676 were indicative of advanced liver fibrosis and scores under -1,455 absence of advanced liver fibrosis. These scores were compared to liver biopsy findings.
  
  
  RESULTS
  The presence of advanced fibrosis could be diagnosed with good accuracy, with a positive predictive value of 83.7%. The score had a higher accuracy to exclude advanced fibrosis with a negative predictive value of 97%. Twenty-five patients (16%) had scores between the cutoffs points and were identified as indeterminate. The score sensibility and specificity was 83% and 97% respectively.
  
  
  CONCLUSIONS
  The nonalcoholic fat liver disease fibrosis score has high accuracy to identify and exclude advanced liver fibrosis in morbidly obese patients subjected to bariatric surgery.
authors: Post Graduation Course on Surgery, Federal University of Paraná, Curitiba, PR, Brazil.
authors: Silvania Klug
authors: SK
authors: Pimentel
authors: Rodrigo
authors: R
authors: Strobel
authors: Carolina Gomes
authors: CG
authors: Gonçalves
authors: Danielle Giacometti
authors: DG
authors: Sakamoto
authors: Flávio Heuta
authors: FH
authors: Ivano
authors: Júlio Cezar Uili
authors: JC
authors: Coelho
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D050110:Bariatric Surgery; D001706:Biopsy; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000601:surgery*; D010976:Platelet Count; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index
chemical_list: D012709:Serum Albumin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase