new clinical score to diagnose nonalcoholic steatohepatitis in obese patients新的临床评分诊断非酒精性脂肪肝炎在肥胖病人.pdfVIP

Pulzi et al. Diabetology Metabolic Syndrome 2011, 3:3 DIABETOLOGY /content/3/1/3 METABOLIC SYNDROME RESEARCH Open Access New clinical score to diagnose nonalcoholic steatohepatitis in obese patients 1 4 4 3 2 1* Fernanda BU Pulzi , Raul Cisternas , Murilo R Melo , Cristiane MF Ribeiro , Carlos A Malheiros , João E Salles Abstract Background: Nonalcoholic fatty liver disease (NAFLD) is the most frequent disease associated with abnormal liver tests that is characterized by a wide spectrum of liver damage, ranging from simple macro vesicular steatosis to steatohepatitis (NASH), cirrhosis or liver carcinoma. Liver biopsy is the most precise test to differentiate NASH from other stages of NAFLD, but it is an invasive and expensive method. This study aimed to create a clinical laboratory score capable of identify individual with NASH in severely obese patients submitted to bariatric surgery. Methods: The medical records from 66 patients submitted to gastroplasty were reviewed. Their chemistry profile, abdominal ultrasound (US) and liver biopsy done during the surgical procedure were analyzed. Patients were classified into 2 groups according to liver biopsy: Non-NASH group - those patients without NAFLD or with grade I, II or III steatosis; and NASH group - those with steatohepatitis or fibrosis. The t-test was used to compare each variable with normal distribution between NASH and Non-NASH groups. When comparing proportions of categorical variables, we used chi-square or z-test, whe