Nonalcoholic steatohepatitis is common in morbidly obese persons.
Liver biopsy is diagnostic but technically challenging in such individuals.
Dr Guilherme Campos and colleagues from California, USA developed a clinically useful scoring system to predict the probability of nonalcoholic steatohepatitis in morbidly obese persons, thus assisting in the decision to perform liver biopsy.
|Hypertension and type 2 diabetes were predictive of nonalcoholic steatohepatitis|
Consecutive subjects undergoing bariatric surgery without evidence of other liver disease underwent intraoperative liver biopsy.
The researcher's main outcome was pathologic diagnosis of nonalcoholic steatohepatitis.
Predictors evaluated were demographic, clinical, and laboratory variables.
The team constructed a clinical scoring system by rounding the estimated regression coefficients for the independent predictors in a multivariate logistic model for the diagnosis ofnonalcoholic steatohepatitis.
Of 200 subjects studied, 64 had nonalcoholic steatohepatitis.
The patient's median body mass index was 48 kg/m2.
The researchers identified 6 predictive factors for nonalcoholic steatohepatitis.
Factors that predicted nonalcoholic steatohepatitis included the diagnosis of hypertension, type 2 diabetes, and sleep apnea.
Aspartate transferase levels more than 27 IU/L, alanine aminotransferase more than 27 IU/L, and non-Black race also predicted nonalcoholic steatohepatitis.
The team derived a nonalcoholic steatohepatitis Clinical Scoring System for Morbid Obesity to predict the probability of nonalcoholic steatohepatitis.
Dr Campos' team concluded, "The proposed clinical scoring can predict nonalcoholic steatohepatitis in morbidly obese persons with sufficient accuracy to be considered for clinical use."
"Identifying a very high-risk group in whom liver biopsy would be very likely to detect nonalcoholic steatohepatitis, as well as a low-risk group in whom biopsy can be safely delayed or avoided."