| Autor: |
Ali AH; Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA., Petroski GF; Biostatistics and Research Design Unit, School of Medicine, University of Missouri, Columbia, MO 65212, USA., Diaz-Arias AA; Boyce & Bynum Pathology Professional Services, Columbia, MO 65201, USA., Al Juboori A; Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA., Wheeler AA; Department of Surgery, University of Missouri, Columbia, MO 65212, USA., Ganga RR; Department of Surgery, University of Missouri, Columbia, MO 65212, USA., Pitt JB; Department of Surgery, University of Missouri, Columbia, MO 65212, USA., Spencer NM; Department of Surgery, University of Missouri, Columbia, MO 65212, USA., Hammoud GM; Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA., Rector RS; Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA.; Research Service, Harry S. Truman Memorial Veterans Medical Center, Columbia, MO 65201, USA.; Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri, Columbia, MO 65212, USA., Parks EJ; Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA.; Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri, Columbia, MO 65212, USA., Ibdah JA; Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA.; Research Service, Harry S. Truman Memorial Veterans Medical Center, Columbia, MO 65201, USA.; Department of Nutrition and Exercise Physiology, School of Medicine, University of Missouri, Columbia, MO 65212, USA.; Department of Medical Pharmacology and Physiology, School of Medicine, University of Missouri Columbia, Columbia, MO 65212, USA. |
| Abstrakt: |
We assessed the relationship between serum alkaline phosphatase (ALP) and liver fibrosis by histology, in addition to other noninvasive parameters, in obese patients undergoing metabolic surgery. Patients scheduled for elective bariatric surgery were prospectively recruited from a bariatric clinic. An intraoperative liver biopsy was performed, and liver histology was evaluated by a pathologist blinded to the patients' data. The endpoint was significant fibrosis defined as fibrosis stage ≥ 2. Independent predictors of fibrosis were identified by logistic regression. Two hundred ten patients were recruited. Liver histology revealed steatosis in 87.1%, steatohepatitis in 21.9%, and significant fibrosis in 10%. Independent predictors of significant fibrosis were ALP (Odds Ratio (OR) 1.03; 95% Confidence interval (CI), 1.01-1.05), alanine aminotransferase (OR 1.02; 95% CI, 1.01-1.03), HbA1c (OR 1.58; 95% CI, 1.20-2.09), and body mass index (OR 1.06; 95% CI, 1.00-1.13). A tree-based model was developed to predict significant fibrosis, with a receiver operating characteristic (ROC) area of 0.845, sensitivity of 0.857, specificity of 0.836, and accuracy of 0.931. The applicability of serum ALP as an independent biomarker of liver fibrosis should be considered in obesity surgery patients, and in the broader context of obese patients with nonalcoholic fatty liver disease. |
