Application of Scores Assessing Histological Activity and Estimated Long-Term Risk Analysis of Hepatic Decompensation of Non-Alcoholic Fatty Liver Disease in Individuals Undergoing Bariatric Surgery.

Autor: Hatto M; Depatment of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Sao Paulo, Campinas, Brazil., Ivano VK; Depatment of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Sao Paulo, Campinas, Brazil., Gestic MA; Depatment of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Sao Paulo, Campinas, Brazil., Utrini MP; Depatment of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Sao Paulo, Campinas, Brazil., Chaim FDM; Depatment of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Sao Paulo, Campinas, Brazil., Callejas-Neto F; Depatment of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Sao Paulo, Campinas, Brazil., Chaim EA; Depatment of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Sao Paulo, Campinas, Brazil., Cazzo E; Depatment of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Sao Paulo, Campinas, Brazil. notrevezzo@yahoo.com.br.; Rua Alexander Fleming, S/No Cidade Universitária Zeferino Vaz, Sao Paulo, CEP, Campinas, 13085-000, Brazil. notrevezzo@yahoo.com.br.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2023 May; Vol. 33 (5), pp. 1580-1586. Date of Electronic Publication: 2023 Apr 01.
DOI: 10.1007/s11695-023-06568-5
Abstrakt: Background: Histological scores can estimate disease staging, allowing a standardization of the assessment of non-alcoholic fatty liver disease (NAFLD). The prediction of risk of NAFLD progression is relevant to allow the planning of interventions.
Objective: To analyze the application of the Iowa NAFLD decompensation risk score, the NAFLD activity score (NAS), and steatosis-activity-fibrosis score (SAF) and to assess correlations between these scores.
Methods: This is a retrospective cross-sectional study enrolling 76 individuals who underwent bariatric surgery at a tertiary university hospital. Liver biopsy was performed during procedures; histological scores were then assessed. The Iowa score was calculated using age, diabetes, and platelet count.
Results: 89.5% were female and mean age was 39.1 ± 9.6 years. Mean BMI was 38.2 ± 3.7 kg/m 2 . Steatosis (92.1%), hepatocellular ballooning (93.4%), lobular inflammation (93.4%), and fibrosis (97.4%) were the commonest histopathological findings. According to NAS, 22.4% had definite non-alcoholic steatohepatitis (NASH). According to SAF, 89.5% had moderate or severe NAFLD. The mean risks of NAFLD decompensation at 5, 10, and 12 years were 0.8%, 2.5%, and 2.9%, respectively. The group whose risk of decompensation was above 10% comprised 2.6% and 5.3% at 10 and 12 years, respectively. The severity assessed by SAF significantly associated with definite NASH diagnosis through NAS (p < 0.001). Iowa score did not correlate with both NAS/SAF scores.
Conclusion: The Iowa score demonstrated that individuals with obesity present with a significant long-term risk of NAFLD-related events. There were high rates of moderate/severe forms of NAFLD assessed by NAS and SAF scores. There were no significant correlations between Iowa and NAS/SAF scores.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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