Prevalence and predictors of non-alcoholic steatohepatitis in subjects with morbid obesity and with or without type 2 diabetes

• Published in: Diabetes & metabolism 2022-09, Vol.48 (5), p.101363-101363, Article 101363
• Main Authors: Lembo, Erminia, Russo, Maria Francesca, Verrastro, Ornella, Anello, Danila, Angelini, Giulia, Iaconelli, Amerigo, Guidone, Caterina, Stefanizzi, Gianluigi, Ciccoritti, Luigi, Greco, Francesco, Sessa, Luca, Riccardi, Laura, Pompili, Maurizio, Raffaelli, Marco, Vecchio, Fabio Maria, Bornstein, Stefan R., Mingrone, Geltrude, Gastaldelli, Amalia, Capristo, Esmeralda
• Format: Article
• Language: English
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2022.101363

AIMTo investigate the prevalence of biopsy-proven non-alcoholic steatohepatitis (NASH) in a cohort of patients with morbid obesity and with or without type 2 diabetes (T2D) and to find non-invasive predictors of NASH severity. METHODSWe evaluated a cohort of 412 subjects (age 19-67 years, body mass index-BMI: 44.98 kg/m2), who underwent fine-needle liver biopsy during bariatric surgery. Thirty-six percent of the subjects were affected by T2D. Liver biopsies were classified according to the Kleiner's NAFLD Activity Score (NAS). NAFLD Fibrosis Score (NFS), AST/ALT ratio, AST to Platelet ratio (APRI), fibrosis-4 score (FIB4) were calculated. A neural network analysis (NNA) was run to predict NASH severity. RESULTSThe prevalence of biopsy-proven NASH was 63% and 78% in subjects with obesity and without or with T2D, respectively. T2D doubled the risk of NASH [OR 2.079 (95% IC=1.31-3.29)]. The prevalence of NAFL increased with the increase of BMI, while there was an inverse correlation between BMI and NASH (r=-0.145 p=0.003). Only mild liver fibrosis was observed. HOMA-IR was positively associated with hepatocyte ballooning (r=0.208, p