Epidemiological surveys suggest that more than half of the obese patients develop nonalcoholic fatty liver disease (NAFLD), which may further advance to nonalcoholic steatohepatitis (NASH) and cirrhosis. The current study was conducted to determine alterations in liver function in obese patients with a noninvasive liver function test.

The current prospective cohort study included 102 morbidly obese patients who were undergoing bariatric surgery. These all patients were investigated for their liver function. Liver function capacity was assessed by the LiMAx® test (enzymatic capacity of cytochrome P450 1A2). Liver biopsy specimens were collected intraoperatively and categorized according to the NAFLD Activity Score (NAS). In addition, NASH clinical score was calculated from laboratory and clinical parameters.

The outcome suggested that median liver function capacity was 286μg/kg/h. 27% of patients were histologically classified as definite NASH, 39% as borderline, and 34% as not NASH. A remarkable association was found between liver function capacity and NAS. The sensitivity and specificity of the LiMAx® test to identify definite NASH and not NASH were 85.2% and 82.9% (AUROC 0.859), respectively. Based on the NASH clinical scoring system, 14% were categorized as low risk, 31% as intermediate, 26% as high, and 29% as very high risk. Furthermore, a significant association existed between liver function capacity and the NASH clinical scoring system.

Thus, the study concluded that obese patients exhibit a reduced liver function capacity, particularly seen in patients suffering from type 2 diabetes. Moreover, the liver function capacity correlates with histological and clinical scoring systems. This study also highlighted the importance of the LiMAx® test, which may act as a tool for noninvasive screening for NASH in obese patients.

Source: Alizai PH, Lurje I, Kroh A, et al. Noninvasive Evaluation of Liver Function in Morbidly Obese Patients. Gastroenterol Res Pract. 2019;2019:4307462. Published 2019 Feb 3.