Accuracy of hepatic elastography through point-share-wave-ARFI in the identification of liver fibrosis and longitudinal follow-up of obese patients who are bariatric surgery candidate

• Grant number: 19/07740-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): August 01, 2019
• Effective date (End): July 31, 2020
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Ana Claudia de Oliveira
• Grantee: Laura Moretti Vidotto
• Host Institution: Escola de Ciências da Saúde (ECS). Universidade Anhembi Morumbi (UAM). Instituto Superior de Comunicação Publicitária (ISCP). São Paulo , SP, Brazil

Abstract

Obesity has been shown to be a highly prevalent health problem worldwide, with an estimated progressive and significant increase in the coming years. Individuals who are overweight and obese are at higher risk of developing equally prevalent and costly chronic non-communicable chronic diseases such as type 2 diabetes mellitus (DM2) and metabolic syndrome (MS). Non-alcoholic fatty liver disease (NAFLD), a recognized component of MS, is strongly associated with overweight and can affect almost 100% of individuals with extreme obesity (BMI e40m2 / kg). This entity presents a broad spectrum of disease, ranging from pure steatosis (ENA) to steatohepatitis (NASH), the latter being characterized by histopathological evidence of inflammation and hepatocellular injury. The recognition of this evolutionary stage has a prognostic implication, since individuals with the most advanced forms of hepatic disease are considered to be at greater risk for the development of complications. However, it is not clear and not very well defined how research should be carried out on the existence and severity of liver disease, particularly in the population of obese candidates for bariatric surgery, and also the importance of this evaluation in the context of weight reduction. Hepatic elastography has emerged as a useful tool for this purpose and has historically been validated for the investigation of chronic hepatitis C. The real role of this feature in NAFLD remains to be established, particularly in the situation of severe obesity, with or without comorbidities. Thus, the present study aims to evaluate the accuracy of ARFI in the identification of liver fibrosis in patients with obesity candidates for bariatric surgery, with liver biopsy as a reference, and its role in longitudinal follow-up.