Less liver fibrosis in metabolically healthy compared with metabolically unhealthy obese patients with non-alcoholic fatty liver disease - 30/09/17
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Abstract |
Aim |
This cross-sectional study evaluated liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD), and compared the characteristics of metabolically healthy obese (MHO) with metabolically unhealthy obese (MUHO) patients.
Methods |
The study was nested within a randomized clinical trial (RCT) and included obese patients with NAFLD, as determined by liver ultrasonography. Fibrosis was assessed by transient elastography, and AST-to-platelet ratio index (APRI) and NAFLD score. Patients were compared according to obesity phenotype using various accepted criteria.
Results |
The RCT included 1024 patients with NAFLD, of whom 428 (41.7%) were included in the present study. The prevalence of MHO ranged from 1.2% to 63%, depending on the criteria used. According to various criteria for metabolic health, obese patients had less liver fibrosis. MHO patients, as defined by all criteria, showed a significantly lower prevalence of advanced liver fibrosis (F3–F4) than MUHO on transient elastography (16.5% vs. 28%, respectively; P≤0.05).
Conclusion |
MUHO patients are at higher risk of liver fibrosis and, therefore, the identification of obese patients with ‘healthy’ characteristics is imperative as their entire clinical work-ups are likely to differ.
El texto completo de este artículo está disponible en PDF.Abbreviations : BMI, MHO, NAFLD, MUHO, RCT, APRI, HOMA-IR, NLP3
Keywords : Chronic liver disease, Fibrosis, Metabolic syndrome, Obesity, Prognosis
Esquema
Vol 43 - N° 4
P. 332-337 - septembre 2017 Regresar al número
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