Hepatic histology in obese patients undergoing bariatric surgery
Hepatic histology in obese patients undergoing bariatric surgery
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DOI：
10.1016/j.jhep.2006.06.013
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发表时间：
2006-10-01
影响因子：
25.7
通讯作者：
Cortez-Pinto, Helena
中科院分区：
文献类型：
--
作者：
Machado, Mariana;Marques-Vidal, Pedro;Cortez-Pinto, Helena
背景/目的：肥胖是非酒精性脂肪性肝炎(NASH)最重要的临床关联之一。我们的目的是评估非酒精性脂肪性肝病(NAFLD)/非酒精性脂肪肝(NASH)在病态肥胖患者中的患病率，以及该人群中更具侵袭性的肝病的危险因素。方法：回顾现有关于接受减肥手术的严重肥胖患者NAFLD/NASH患病率的研究。结果：纳入12项观察性和横向研究，连续招募，并对数据进行前瞻性评估，总计1620名重度肥胖症患者。脂肪变性和NASH的患病率分别为91%(85-98%)和37%(24-98%)，意外肝硬变的患病率为1.7%(1-7%)。NASH与年龄或体重指数无关，但男性与NASH/肝纤维化有关。糖尿病和胰岛素抵抗是NASH最常见的疾病，高血压合并晚期肝纤维化。结论：在无症状的病态肥胖患者中，NAFLD的患病率很高，超过三分之一的患者提出了NASH的组织学标准。这篇综述强调了不同研究之间NASH患病率的巨大差异，呼吁在组织学标准的使用上有更好的一致性。(C)2006年欧洲肝脏研究协会。爱思唯尔出版，版权所有。
Background/Aims: Obesity is one of the most important clinical associations with non-alcoholic steatohepatitis (NASH). Our aim was to assess the prevalence of non-alcoholic fatty liver disease (NAFLD)/NASH in morbidly obese patients and the risk factors to more aggressive liver disease in this population.Methods: Review of available studies on prevalence of NAFLD/NASH in severely obese patients submitted to bariatric surgery.Results: Twelve observational and transversal studies were included, with consecutive recruitment, and prospective evaluation of data, summing 1620 patients with severe obesity. Prevalence of steatosis and NASH was 91% (range: 85-98%) and 37% (24-98%), respectively, with unexpected cirrhosis in 1.7% (1-7%). NASH was not related with age or body mass index, but there was an association between male sex and NASH/hepatic fibrosis. Diabetes mellitus and insulin resistance were the conditions most frequently associated with NASH, and hypertension with advanced hepatic fibrosis.Conclusions: There is a very high prevalence of NAFLD in asymptomatic morbidly obese patients, more than one-third presenting histological criteria for NASH. This review underscores the large variations in prevalence of NASH between studies, calling for the need for a better agreement in the use of the histological criteria. (c) 2006 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.