Understanding Liver Disease in the Obese

A new study looks at what is associated with a form of fatty liver disease that can lead to advanced liver disease. For the study, researchers looked at the livers of patients undergoing gastric bypass surgery.

Nonalcoholic fatty liver disease is found in 65 percent of obese people and is believed to happen in 90 percent of those morbidly obese. While nonalcoholic fatty liver disease is relatively benign, nonalcoholic steatohepatitis (NASH) is a form of fatty liver disease that is a concern. NASH can progress to fibroids which can then lead to cirrhosis and end-stage liver disease. The problem is in many cases of NASH there are no symptoms until it progresses to advanced liver disease. Researchers from the University of Washington School of Medicine looked at the risk factors for NASH in patients who were undergoing gastric bypass surgery.

Forty-eight patients agreed to have a liver biopsy done when they were having gastric bypass surgery. Researchers did not include patients who reported drinking more than two alcoholic beverages a day or who had cirrhosis. Study authors looked at who had NASH or severe fibrosis, the body mass index of the patient, the triglycerides level, and if the patient had diabetes.

Researchers report 33 percent of the patients had NASH and 12 percent had fibrosis. They also found 65 percent of the patients had moderate to severe fatty liver disease. Researchers report no difference in the age, sex, body mass index or triglyceride level between patients with and without NASH or advanced fibrosis. They also report the odds of NASH were 128-times greater and the odds of severe fibrosis 75-times greater in patients with diabetes. Researchers say the body mass index of the patient before the surgery was not associated with the likelihood of having NASH or severe fibrosis.

Study authors conclude fatty liver disease and NASH is common among patients undergoing gastric bypass procedures. They say diabetes and not body mass index is associated with NASH and the progression of fibrosis.

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