Fatty Liver Disease Hard to Stage in Morbidly Obese

Morbidly obese patients are harder to assess when it comes to phenotyping the spectrum of nonalcoholic fatty liver disease (NAFLD). Those who have NAFLD could have either nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH).

Reporting at the American College of Gastroenterologists Annual Scientific Meeting in Honolulu Oct. 16 to Oct. 22, Sasha Mangray, MBBS, MD, of Virginia Commonwealth University, Richmond, VA, and colleagues said these patients' status was hard to assess.

Liver biopsy is required to do the phenotyping and also helps in staging liver fibrosis.The researchers wanted to compare these definitive biopsy results with those from noninvasive tests.

The NAFLD fibrosis score was developed to accurately stratify subjects without a biopsy into low and high fibrosis groups.

But when patients have a BMI score of greater than 40, "there was a marked discordance between fibrosis on liver histology and non-invasive NAFLD fibrosis score."

The liver histology exam was done on patients who had bariatric surgery.

"These findings suggest poor predictability of currently available non-invasive tests," they wrote in a paper presented at the conference. "There is a pressing need to further explore other non-invasive methods and models that are readily available, affordable easily accessible, and reproducible," they concluded.