title: Non-Alcoholic Steatohepatitis (NASH): Risk Factors in Morbidly Obese Patients.
abstract: The aim was to investigate the prevalence of non-alcoholic steatohepatitis (NASH) and risk factors for hepatic fibrosis in morbidly obese patients submitted to bariatric surgery. This retrospective study recruited all patients submitted to bariatric surgery from January 2007 to December 2012 at a reference attendance center of Southern Brazil. Clinical and biochemical data were studied as a function of the histological findings of liver biopsies done during the surgery. Steatosis was present in 226 (90.4%) and NASH in 176 (70.4%) cases. The diagnosis of cirrhosis was established in four cases (1.6%) and fibrosis in 108 (43.2%). Risk factors associated with NASH at multivariate analysis were alanine aminotransferase (ALT) >1.5 times the upper limit of normal (ULN); glucose ≥ 126 mg/dL and triglycerides ≥ 150 mg/dL. All patients with ALT ≥1.5 times the ULN had NASH. When the presence of fibrosis was analyzed, ALT > 1.5 times the ULN and triglycerides ≥ 150 mg/dL were risk factors, furthermore, there was an increase of 1% in the prevalence of fibrosis for each year of age increase. Not only steatosis, but NASH is a frequent finding in MO patients. In the present study, ALT ≥ 1.5 times the ULN identifies all patients with NASH, this finding needs to be further validated in other studies. Moreover, the presence of fibrosis was associated with ALT, triglycerides and age, identifying a subset of patients with more severe disease.
authors.affiliation: Post-Graduation Program, Hepatology at Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90.050-170, Brasil. alosekann@gmail.com.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Losekann
authors.affiliation: Centro de Tratamento da Obesidade (CTO), Hospital Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 92.010-300, Brasil. drweston@terra.com.br.
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Weston
authors.affiliation: Post-Graduation Program, Hepatology at Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90.050-170, Brasil. angeloamattos@gmail.com.
authors.forename: Angelo A
authors.initials: AA
authors.lastname: de Mattos
authors.affiliation: Post-Graduation Program, Hepatology at Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90.050-170, Brasil. cris.tovo@terra.com.br.
authors.forename: Cristiane V
authors.initials: CV
authors.lastname: Tovo
authors.affiliation: Centro de Tratamento da Obesidade (CTO), Hospital Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 92.010-300, Brasil. luizdecarli@plugin.com.br.
authors.forename: Luis A
authors.initials: LA
authors.lastname: de Carli
authors.affiliation: Centro de Tratamento da Obesidade (CTO), Hospital Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 92.010-300, Brasil. mariliae@brturbo.com.br.
authors.forename: Marilia B
authors.initials: MB
authors.lastname: Espindola
authors.affiliation: Centro de Tratamento da Obesidade (CTO), Hospital Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 92.010-300, Brasil. srpioner@terra.com.br.
authors.forename: Sergio R
authors.initials: SR
authors.lastname: Pioner
authors.affiliation: Post-Graduation Program, Hepatology at Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90.050-170, Brasil. g.coral@terra.com.br.
authors.forename: Gabriela P
authors.initials: GP
authors.lastname: Coral
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D005355:Fibrosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000453:epidemiology*; D009767:Obesity, Morbid / Q000150:complications* / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D000410:Alanine Transaminase
keywords: NAFLD; NASH; liver fibrosis; morbidly obese