Noninvasive Evaluation of Liver Function in Morbidly Obese Patients
Background. More than half of the obese patients develop nonalcoholic fatty liver disease (NAFLD), which may further progress to nonalcoholic steatohepatitis (NASH) and cirrhosis. The aim of this study was to assess alterations in liver function in obese patients with a noninvasive liver function te...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/4307462 |
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| author | Patrick H. Alizai Isabella Lurje Andreas Kroh Sophia Schmitz Tom Luedde Julia Andruszkow Ulf P. Neumann Florian Ulmer |
| author_facet | Patrick H. Alizai Isabella Lurje Andreas Kroh Sophia Schmitz Tom Luedde Julia Andruszkow Ulf P. Neumann Florian Ulmer |
| author_sort | Patrick H. Alizai |
| collection | DOAJ |
| description | Background. More than half of the obese patients develop nonalcoholic fatty liver disease (NAFLD), which may further progress to nonalcoholic steatohepatitis (NASH) and cirrhosis. The aim of this study was to assess alterations in liver function in obese patients with a noninvasive liver function test. Methods. In a prospective cohort study 102 morbidly obese patients undergoing bariatric surgery were evaluated for their liver function. Liver function capacity was determined by the LiMAx® test (enzymatic capacity of cytochrome P450 1A2). Liver biopsy specimens were obtained intraoperatively and classified according to the NAFLD Activity Score (NAS). NASH clinical score was additionally calculated from laboratory and clinical parameters. Results. Median liver function capacity was 286 (IQR=141) μg/kg/h. 27% of patients were histologically categorized as definite NASH, 39% as borderline, and 34% as not NASH. A significant correlation was observed between liver function capacity and NAS (r=−0.492; p<0.001). The sensitivity and specificity of the LiMAx® test to distinguish between definite NASH and not NASH were 85.2% and 82.9% (AUROC 0.859), respectively. According to the NASH clinical scoring system, 14% were classified as low risk, 31% as intermediate, 26% as high, and 29% as very high risk. Liver function capacity is also significantly correlated with the NASH clinical scoring system (r=−0.411; p<0.001). Conclusions. Obese patients show a diminished liver function capacity, especially those suffering from type 2 diabetes. The liver function capacity correlates with histological and clinical scoring systems. The LiMAx® test may be a valuable tool for noninvasive screening for NASH in obese patients. |
| format | Article |
| id | doaj-art-47ab195e356b48a385a8bf91a4a4137b |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-47ab195e356b48a385a8bf91a4a4137b2025-02-03T05:57:07ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/43074624307462Noninvasive Evaluation of Liver Function in Morbidly Obese PatientsPatrick H. Alizai0Isabella Lurje1Andreas Kroh2Sophia Schmitz3Tom Luedde4Julia Andruszkow5Ulf P. Neumann6Florian Ulmer7Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, GermanyDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, GermanyDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, GermanyDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, GermanyDepartment of Gastroenterology, Digestive Diseases and Intensive Care Medicine, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, GermanyInstitute of Pathology, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, GermanyDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, GermanyDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, GermanyBackground. More than half of the obese patients develop nonalcoholic fatty liver disease (NAFLD), which may further progress to nonalcoholic steatohepatitis (NASH) and cirrhosis. The aim of this study was to assess alterations in liver function in obese patients with a noninvasive liver function test. Methods. In a prospective cohort study 102 morbidly obese patients undergoing bariatric surgery were evaluated for their liver function. Liver function capacity was determined by the LiMAx® test (enzymatic capacity of cytochrome P450 1A2). Liver biopsy specimens were obtained intraoperatively and classified according to the NAFLD Activity Score (NAS). NASH clinical score was additionally calculated from laboratory and clinical parameters. Results. Median liver function capacity was 286 (IQR=141) μg/kg/h. 27% of patients were histologically categorized as definite NASH, 39% as borderline, and 34% as not NASH. A significant correlation was observed between liver function capacity and NAS (r=−0.492; p<0.001). The sensitivity and specificity of the LiMAx® test to distinguish between definite NASH and not NASH were 85.2% and 82.9% (AUROC 0.859), respectively. According to the NASH clinical scoring system, 14% were classified as low risk, 31% as intermediate, 26% as high, and 29% as very high risk. Liver function capacity is also significantly correlated with the NASH clinical scoring system (r=−0.411; p<0.001). Conclusions. Obese patients show a diminished liver function capacity, especially those suffering from type 2 diabetes. The liver function capacity correlates with histological and clinical scoring systems. The LiMAx® test may be a valuable tool for noninvasive screening for NASH in obese patients.http://dx.doi.org/10.1155/2019/4307462 |
| spellingShingle | Patrick H. Alizai Isabella Lurje Andreas Kroh Sophia Schmitz Tom Luedde Julia Andruszkow Ulf P. Neumann Florian Ulmer Noninvasive Evaluation of Liver Function in Morbidly Obese Patients Gastroenterology Research and Practice |
| title | Noninvasive Evaluation of Liver Function in Morbidly Obese Patients |
| title_full | Noninvasive Evaluation of Liver Function in Morbidly Obese Patients |
| title_fullStr | Noninvasive Evaluation of Liver Function in Morbidly Obese Patients |
| title_full_unstemmed | Noninvasive Evaluation of Liver Function in Morbidly Obese Patients |
| title_short | Noninvasive Evaluation of Liver Function in Morbidly Obese Patients |
| title_sort | noninvasive evaluation of liver function in morbidly obese patients |
| url | http://dx.doi.org/10.1155/2019/4307462 |
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