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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Use of noninvasive markers to predict advanced fibrosis/cirrhosis in severe obesity

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Author(s):
de Cleva, Roberto [1] ; Duarte, Livio Fiolo [1] ; Furst Crenitte, Milton Roberto [1] ; Marques de Oliveira, Claudia Pinto [1] ; Pajecki, Denis [1] ; Santo, Marco Aurelio [1]
Total Authors: 6
Affiliation:
[1] Univ Sao Paulo, Sch Med, Dept Gastroenterol, Sao Paulo - Brazil
Total Affiliations: 1
Document type: Journal article
Source: Surgery for Obesity and Related Diseases; v. 12, n. 4, p. 862-867, MAY 2016.
Web of Science Citations: 1
Abstract

Background: Nonalcoholic steatohepatitis is observed in 25%-55% of patients with severe obesity and in 2%-12% with bridging fibrosis or cirrhosis. There is currently no noninvasive test for the diagnosis of severe liver fibrosis before bariatric surgery. Objectives: To determine the best noninvasive test for predicting advanced liver disease in patients with severe obesity. Setting: University tertiary care hospital, Brazil. Methods: A cross-sectional retrospective study was conducted with 699 patients with severe obesity undergoing bariatric surgery: 568 without a biopsy (nonbiopsy cohort) and 131 patients who had undergone an intraoperative liver biopsy. The tissues were subjected to histologic diagnosis (Brunt criteria) and classified as advanced fibrosis (stages 3 and 4) or no significant fibrosis (absence of nonalcoholic steatohepatitis and stages 1 or 2). The following predictive indices of cirrhosis were calculated in all patients: aspartate aminotransferase/alanine aminotransferase ratio (AAR), age platelet (AP) index, aminotransferase-to-platelet ratio index (APRI), cirrhosis discriminant score (CDS), and hepatitis C antiviral long-term treatment against cirrhosis (HALT-C). The cutoff values, sensitivity, specificity, and areas under the receiver operating characteristic curves (AUROCs) were calculated for patients with biopsies. Results: The AUROC of the AAR, AP, APRI, CDS, and HALT-C model for predicting advanced fibrosis or cirrhosis were, respectively, .522, .88, .99, .905, and .921. The calculated cutoff values, sensitivity, and specificity, respectively, were as follows: AAR: .94, .7, .45; AP 5, .7, .93; APRI .44, 1.0, .97; CDS 6, .7, .97; and HALT-C: .76, 1.0, .77. Conclusion: APRI index was the best predictor of advanced liver disease in patients with severe obesity. (Surg Obes Relat Dis 2016;12:862-867.) (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved. (AU)

FAPESP's process: 10/09441-1 - APRI index in morbidity obesity before and after bariatric surgery
Grantee:Milton Roberto Furst Crenitte
Support Opportunities: Scholarships in Brazil - Scientific Initiation