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Título: Evaluation of Noninvasive Methods for Preoperative Diagnosis of Advanced Liver Fibrosis or Hepatic Cirrhosis in Morbid Obesity
Citación: OBESITY SURGERY, v.22, n.9, p.1408-1408, 2012
Resumen: Introduction Currently obesity is an epidemic in Western society, with significant increase in prevalence. There are several comorbidities such as systemic hypertension, insulin resistance, dyslipidemia and NAFLD/NASH (Nonalcoholic Fatty Liver Diasease/Non alcoholic steatohepatitis). The liver biopsy is the gold standard for diagnosis of this condition. Due to several difficulties with this method, we compare some non-invasive markers for identification of severe/advanced fibrosis and cirrhosis. Materials & Methods We studied 638 patients undergoing bariatric surgery. Among them, 83 patients underwent liver biopsy. The laboratory data were obtained from medical records, and calculated the following markers: AAR, AP index, APRI, CDS and HALT-C. Using biopsies, performed in part of the serie (n=084), as a control group, statistical analysis was performed to identify the best method and cutoff values. Results The more accurate method was APRI, with a cutoff value of 0.6 (sensitivity and specificity, CI, PPV and NPV were calculated). In the group of patients who underwent biopsy, 5 had advanced fibrosis or cirrhosis (6.02 %) and 25 some degree of fibrosis (30.12 %). Discussion In the population studied, the percentages of fibrosis/cirrhosis, and some degree of NAFLD are compatible with literature data. The APRI index would be useful as a predictor in all cases of advanced fibrosis/cirrhosis in this serie. Conclusion Regarding the markers studied, the APRI was the best method to predict advanced liver disease. Thus, it can apparently be used as a screening method for performing liver biopsies.
Aparece en las colecciones:

Comunicações em Eventos - FM/MGT
Departamento de Gastroenterologia - FM/MGT

Comunicações em Eventos - HC/ICHC
Instituto Central - HC/ICHC

Comunicações em Eventos - HC/InCor
Instituto do Coração - HC/InCor

Comunicações em Eventos - LIM/35
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo

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