Abdel Rahman Abdulla Al Manasra
Jordan University of Science and Technology, Jordan
Title: Prevalence and patterns of Non-alcoholic fatty liver disease among morbidly obese patients undergoing sleeve gastrectomy
Biography
Biography: Abdel Rahman Abdulla Al Manasra
Abstract
Background & Aim: Obesity related non-alcoholic fatty liver disease (NAFLD) is increasingly recognized worldwide. Multiple predictive and risk factors have been proposed for NAFLD. We aim to describe the prevalence, histologic patterns, and risk factors for this disease in morbidly obese patients undergoing sleeve gastrectomy.
Methods: This is a prospective study, which included a cohort of 49 obese patients undergoing sleeve gastrectomy with concomitant true cut liver biopsy. Patients were excluded when they have history of alcohol intake, liver disease, or hepatotoxic agents’ intake. Clinical, biochemical, and histological features were evaluated. Histological patterns were classified based on the NIH-sponsored NASH Clinical Research Network NAFLD Activity Score (NAS).
Results: Most patients were females (73%), with mean age of 34 (range 17-58). Mean BMI was 43 (35-52). 45 patients (91.8%) showed NAFLD, 19 (39%) showed non-alcoholic steatohepatitis (NASH) and 5 (10%) showed fibrosis. Only 4 biopsies (8%) were reported as normal. Significant correlation was found between low-density lipoprotein (LDL) vs. NASH (P=0.005), LDL vs. steatosis grade (P=0.023), aspartate aminotransferase (AST) vs. NAS (P=0.005), AST vs. steatosis grade (P=0.009), glucose vs. steatosis (P=0.006), sex vs. NAFLD (P=0.02), and sex vs. hepatocyte ballooning (P=0.005). There was no morbidity or mortality in this study.
Conclusion: NAFLD has a very high prevalence among morbidly obese patients. Significant correlation is evident between biochemical markers and histological components of liver assessment. Intraoperative liver biopsy is safe in morbidly obese patients undergoing sleeve gastrectomy for the diagnosis of NAFLD.