Format

Send to

Choose Destination
Obes Surg. 2018 Mar;28(3):735-742. doi: 10.1007/s11695-017-2914-0.

Non-invasive Evaluation of NAFLD with Indocyanine Green Clearance Test: a Preliminary Study in Morbidly Obese Patients Undergoing Bariatric Surgery.

Danin PE1,2,3, Anty R2,3,4,5, Patouraux S2,3,6,7, Raucoules-Aimé M1,3, Gugenheim J2,3,4,8, Tran A2,3,4,5, Gual P9,10,11, Iannelli A12,13,14,15,16.

Author information

1
Anesthesia and Intensive care, L'Archet 2 Hospital, University Hospital of Nice, Archet 2 151 Route Saint Antoine de Ginestière, BP 3079, 062014, Nice, Cedex 3, France.
2
INSERM, U1065, C3M, Team 8 « Hepatic complications in obesity », 151 route Saint Antoine de Ginestière, BP 2 3194, 06204, Nice, Cedex 3, France.
3
Université Côte d'Azur, Nice, France.
4
CHU of Nice, Digestive Center, L'Archet 2 Hospital, University Hospital of Nice, Nice, France.
5
Digestive Unit, Archet 2 Hospital, 151 Route Saint Antoine de Ginestière, BP 3079, 06204, Nice, Cedex 3, France.
6
CHU of Nice, Biological Center, Pasteur Hospital, University Hospital of Nice, Nice, France.
7
Biological Center, Archet 2 Hospital, 151 Route Saint Antoine de Ginestière BP 3079, Nice, 06204, Cedex 3, France.
8
Department of Digestive Surgery, Hôpital Archet 2, 151 Route Saint Antoine de Ginestière, BP3079, 06204, Nice, Cedex 3, France.
9
INSERM, U1065, C3M, Team 8 « Hepatic complications in obesity », 151 route Saint Antoine de Ginestière, BP 2 3194, 06204, Nice, Cedex 3, France. philippe.gual@inserm.fr.
10
Université Côte d'Azur, Nice, France. philippe.gual@inserm.fr.
11
Inserm U1065, Bâtiment Universitaire ARCHIMED, Equipe 8 "Complications hépatiques de l'obésité", 151 route Saint Antoine de Ginestière, BP 2 3194, 06204, Nice, Cedex 3, France. philippe.gual@inserm.fr.
12
INSERM, U1065, C3M, Team 8 « Hepatic complications in obesity », 151 route Saint Antoine de Ginestière, BP 2 3194, 06204, Nice, Cedex 3, France. iannelli.a@chu-nice.fr.
13
Université Côte d'Azur, Nice, France. iannelli.a@chu-nice.fr.
14
CHU of Nice, Digestive Center, L'Archet 2 Hospital, University Hospital of Nice, Nice, France. iannelli.a@chu-nice.fr.
15
Department of Digestive Surgery, Hôpital Archet 2, 151 Route Saint Antoine de Ginestière, BP3079, 06204, Nice, Cedex 3, France. iannelli.a@chu-nice.fr.
16
Centre Hospitalier Universitaire de Nice, Service de Chirurgie Digestive et Transplantation Hépatique, Hôpital de l'Archet, Pôle Digestif, 151 route Saint Antoine de Ginestière, 06200, Nice, Cedex, France. iannelli.a@chu-nice.fr.

Abstract

BACKGROUND:

Overweight and obesity dramatically increased in the last years. Hepatic complication of obesity, integrated in the term of non-alcoholic fatty liver disease (NAFLD), is a spectrum of abnormality ranging from steatosis to non-alcoholic steatohepatitis (NASH), potentially leading to cirrhosis. Liver biopsy remains the gold standard to evaluate the stage of NAFLD; however, the procedure is invasive. The indocyanine green (ICG) clearance test is performed since years to assess hepatic function before partial hepatectomy, or after liver transplantation. This study was designed to detect liver complications with the ICG clearance test in a population of obese patients scheduled for bariatric surgery.

METHODS:

In a prospective cohort study, morbidly obese individuals receiving bariatric surgery with scheduled hepatic biopsies were investigated. Liver function was determined by the ICG test preoperatively, and blood samples were collected. Liver biopsy specimens were obtained for each patient and classified according to the NAFLD activity score (NAS) by a single pathologist that was blinded to the results of the ICG test.

RESULTS:

Twenty-six patients were included (7 male and 19 female). The mean age of participants was 45.8 years; the mean body mass index was 41.4 kg/m2. According to the NAS, 6 (23.1%) patients revealed manifest NASH, and 5 patients were considered borderline (19.2%). A closed correlation was observed between the ICG clearance test and hepatic steatosis (r = 0.43, p = 0.03), NAS (r = 0.44, p = 0.025), and fibrosis (r = 0.49, p = 0.01).

CONCLUSIONS:

In obese patients, non-invasive evaluation of liver function with the indocyanine green clearance test correlated with histological features of NAFLD. This may detect non-invasively hepatopathy in obese population and could motive biopsy.

KEYWORDS:

Diagnosis; Fibrosis; NAFLD; NASH; Steatosis

PMID:
28875438
DOI:
10.1007/s11695-017-2914-0

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center