| BackgroundNonalcoholic steatohepatitis(NASH)is an inflammatory subtype of nonalcoholic fatty liver disease(NAFLD).Compared with the slow progression of nonalcoholic fatty liver(NAFL),liver fibrosis caused by NASH increases by one grade every 10 years,and it will greatly increase the prevalence of end-stage liver diseases such as liver cirrhosis and hepatocellular carcinoma.The prevalence ofNASH in the obese population is much higher than that in the general population,but clinical data in this regard are lacking in our country.This study aims to identify the prevalence and risk factors of NASH and liver fibrosis in the obese population in our country and to remind people to pay attention to the screening and treatment of NASH in the obese population.MethodsA total of 77 obese patients who underwent bariatric surgery plus liver biopsy were included in this retrospective study.These patients were divided into the NASH group and the no-NASH group based on the pathological diagnosis of liver biopsy and NAFLD activity score(NAS).According to the presence or absence of liver fibrosis,these patients were divided into liver fibrosis group and no-liver fibrosis group.The demographic data and laboratory data were collected and analyzed by SPSS Software to investigate the prevalence and risk factors of NASH and liver fibrosis in obese patients.P<0.05 was considered statistically significant.ResultsOf the 77 patients included in this study,29 cases(37.7%)were male and 48 cases(62.3%)were female.The mean age was 30.39±7.65(18-56)years.The mean body mass index(BMI)was 41.78±6.56(30.00-58.40)kg/m2.Combined with liver biopsy results,45(58.4%)patients were diagnosed with NASH and 55(71.4%)with liver fibrosis.The single-factor analysis found that there were significant differences in BMI(39.36±6.15 kg/m2 vs 43.50±6.36 kg/m2),alanine transaminase(30.85±20.49 IU/L vs 58.12±46.70 IU/L),aspartate transaminase(21.49±9.37 IU/L vs 39.43±43.81 IU/L)and type 2 diabetes mellitus(8 cases vs 24 cases)between NASH group and no-NASH group(P<0.05).In the liver fibrosis group and the no-liver fibrosis group,there were significant differences in BMI(38.90±5.60 kg/m2 vs 42.93±6.60 kg/m2),alanine transaminase(26.05±19.14 IU/L vs 55.07±43.45 IU/L),aspartate transaminase(19.40±8.49 IU/L vs 37.00±40.09 IU/L),y-glutamyl transpeptidase(43.60±28.22 IU/L vs 56.53±23.37 IU/L)and type 2 diabetes mellitus(3 cases vs 29 cases)(P<0.05).Further binary logistic regression analysis showed that BMI was an independent risk factor for NASH(OR=1.110,95%CI=1.017-1.212,P=0.020),type 2 diabetes mellitus was an independent risk factor for liver fibrosis(OR=5.805,95%CI=1.399-24.081,P=0.015).Conclusion1.The prevalence of NASH and liver fibrosis is 58.4%and 71.4%,among obese patients who underwent bariatric surgery.2.BMI is an independent risk factor for NASH,while Type 2 diabetes mellitus is an independent risk factor for liver fibrosis.3.Obese people in our country are more likely to develop NASH,but their average BMI is lower than that of Western countries such as the United States.Therefore,we should pay more attention to the screening of NASH and liver fibrosis in obese patients,especially those with type 2 diabetes mellitus,and further study the therapeutic methods for NASH and liver fibrosis,to find and treat NASH as early as possible. |
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