Authors: Alex Ulitsky Ashwin N Ananthakrishnan Richard Komorowski James Wallace Sri Naveen Surapaneni Jose Franco Kia Saeian Samer Gawrieh
Publish Date: 2010/03/25
Volume: 20, Issue: 6, Pages: 685-691
Abstract
A simple model to predict nonalcoholic steatohepatitis NASH in patients with nonalcoholic fatty liver disease is desirable to optimize the selection of patients for liver biopsy We investigated a large group of morbidly obese patients to derive a scoring system based on simple clinical and laboratory variablesConsecutive subjects undergoing bariatric surgery and without evidence of other liver disease or significant alcohol use underwent intraoperative liver biopsy Demographic clinical and biochemical variables were collected A scoring model was derived using variables found to be independent predictors of NASH The scores were divided into four risk categories low intermediate high and very high Positive and negative predictive values PPV/NPV were derived for each category and the area under the receiver operator curve AUROC was calculatedA total of 253 subjects were included 52 206 had NASH 116 458 had simple steatosis and 85 336 had normal liver histology Only ten subjects 19 of NASH group had significant ≥ stage 2 fibrosis Multivariate analysis identified diabetes abnormal ALT and hypertriglyceridemia as independent predictors of NASH Sleep apnea showed a strong trend toward significance and was also included in the model This model showed a NPV of 897 in the low risk category and a PPV of 75 in the very high risk category with AUROC of 076
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