title: NONALCOHOLIC FATTY LIVER DISEASE AND ITS COMPLICATIONS--ASSESSING THE POPULATION AT RISK. A SMALL SERIES REPORT AND LITERATURE REVIEW.
abstract: The aim of the study was to highlight correlations between serum biochemical markers and different degrees of liver inflammation or fibrosis revealed by liver biopsy in morbidly obese patients. We also wanted to emphasize that the occurrence of hepatocellular carcinoma (HCC) is increasingly associated with obesity, metabolic syndrome and nonalcoholic fatty liver disease.
  
  
  METHODS
  A clinical retrospective study was carried out on a series of 13 patients operated for morbid obesity in our surgical unit. Included in this study were only the obese patients referred for bariatric surgery without other risk factors for liver disease and in whom a liver biopsy was taken during metabolic surgery.
  
  
  RESULTS
  The pathology report revealed different stages of nonalcoholic fatty liver disease in all 13 patients: pathological features of steatohepatitis (7 patients), hepatic steatosis (5 patients) and lesions specific for evolving cirrhosis (1 patient). Regardless of the pathological changes of the liver, except the patient with evolving cirrhosis, none of these patients showed changes in classical liver function blood tests.
  
  
  CONCLUSIONS
  Hepatic alteration in obese patients, ranging from simple steatosis to steatohepatitis or even cirrhosis, is not always correlated with the values of classical biological liver function tests. Literature data suggest the involvement of adipokines in the development and progression of steatosis as the hepatic expression of metabolic and chronic inflammation syndrome occurring in obese patients. Furthermore, these proteins secreted by adipose tissue seem to be related to the HCC occurrence. However, none of these studies show the exact pathway followed by the hepatic cell from simple fatty liver to hepatocellular carcinoma.
  
  
  CONCLUSIONS
  finding and selecting the population at risk for fatty liver disease progression and for HCC development among obese patients is mandatory.
authors.forename: Roxana
authors.initials: R
authors.lastname: Livadariu
authors.forename: D
authors.initials: D
authors.lastname: Timofte
authors.forename: R
authors.initials: R
authors.lastname: Danilă
authors.forename: Lidia
authors.initials: L
authors.lastname: Ionescu
authors.forename: C
authors.initials: C
authors.lastname: Diaconu
authors.forename: P
authors.initials: P
authors.lastname: Soroceanu
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Sângeap
authors.forename: V L
authors.initials: VL
authors.lastname: Drug
authors.forename: Anca
authors.initials: A
authors.lastname: Trifan
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D050110:Bariatric Surgery; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000150:complications; D018450:Disease Progression; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000209:etiology*; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D054392:Adipokines; D015415:Biomarkers