Evaluation of liver function tests and risk score assessment to screen patients for significant liver disease prior to bariatric and metabolic surgery

Antipass, Anthony; Austin, Andrew; Awad, Sherif; Hughes, David; Idris, Iskandar

Abstract

Bariatric and metabolic surgery is associated with significant improvement in obesity-related comorbidities, but for patients with non-alcoholic fatty liver disease (NAFLD), clinical outcomes are dependent on the severity of liver disease, i.e. improvement of NAFLD in most patients but increased risks of fulminant hepatic failure and/or bleeding varices in patients with more advanced cirrhosis. Our study showed that absolute values of liver enzymes were poor indicator of risk of liver fibrosis. The use of AST/ALT ratio, Fib 4 or NAFLD scores were appropriate screening tools, with each risk score appearing to pick out a certain phenotype of patients based on age, BMI or individual values of ALT, AST or platelet count. There is lack of agreement in some cases between FIB-4 scores and NAFLD scores when ruling out patients at high risk of liver fibrosis. Meticulous screening of patients at risk of liver fibrosis is crucial in order to reduce the risk of liver-related complications following bariatric and metabolic surgery.

Citation

Antipass, A., Austin, A., Awad, S., Hughes, D., & Idris, I. (2020). Evaluation of liver function tests and risk score assessment to screen patients for significant liver disease prior to bariatric and metabolic surgery. Obesity Surgery, 30, 2840–2843. https://doi.org/10.1007/s11695-020-04486-4

• Journal Article Type: Article
• Acceptance Date: Feb 12, 2020
• Online Publication Date: Mar 2, 2020
• Publication Date: 2020-07
• Deposit Date: Mar 3, 2020
• Publicly Available Date: Mar 3, 2020
• Journal: Obesity Surgery
• Print ISSN: 0960-8923
• Electronic ISSN: 1708-0428
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 30
• Pages: 2840–2843
• DOI: https://doi.org/10.1007/s11695-020-04486-4
• Keywords: Surgery; Nutrition and Dietetics; Endocrinology, Diabetes and Metabolism
• Public URL: https://nottingham-repository.worktribe.com/output/4082688
• Publisher URL: https://link.springer.com/article/10.1007/s11695-020-04486-4