title: Serologic predictors of nonalcoholic steatohepatitis in a population undergoing bariatric surgery.
abstract: BACKGROUND
  Nonalcoholic steatohepatitis (NASH) is common in the morbidly obese. It is a condition that can lead to progressive fibrosis and cirrhosis. We determined the prevalence in a population undergoing bariatric surgery and evaluated the possible serologic predictors before the development of fibrosis.
  
  
  METHODS
  Liver biopsies were taken from 370 consecutive patients who were undergoing laparoscopic bariatric surgery. The clinical and biochemical parameters were then assessed for correlation with the histologic features of nonalcoholic steatohepatitis.
  
  
  RESULTS
  Of the 370 patients, 68 (18%) were found to have NASH. Increased insulin resistance, alanine transaminase, and total bilirubin were independently associated with the presence of NASH. The presence of ≥ 2 of the 3 provided the best combination of sensitivity (.71) and specificity (.71) for predicting NASH.
  
  
  CONCLUSIONS
  Increased insulin resistance, alanine transaminase, and total bilirubin are serologic predictors for the presence of NASH before the development of fibrosis.
authors.affiliation: Department of General and Digestive Surgery, Flinders Medical Centre and Adelaide Bariatric Centre, South Australia, Australia. jacob.chisholm@health.sa.gov.au
authors.forename: Jacob
authors.initials: J
authors.lastname: Chisholm
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Seki
authors.forename: James
authors.initials: J
authors.lastname: Toouli
authors.forename: Jurgen
authors.initials: J
authors.lastname: Stahl
authors.forename: Jane
authors.initials: J
authors.lastname: Collins
authors.forename: Lilian
authors.initials: L
authors.lastname: Kow
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D050110:Bariatric Surgery / Q000379:methods; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001707:Biopsy, Needle; D005234:Fatty Liver / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D010535:Laparoscopy / Q000379:methods; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D012372:ROC Curve
chemical_list: D015415:Biomarkers; D000410:Alanine Transaminase; D001663:Bilirubin