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Semin Liver Dis 2004; 24(4): 363-370
DOI: 10.1055/s-2004-860865
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Liver Pathology in Obesity

Arief Suriawinata1 , M. Isabel Fiel2
  • 1Assistant Professor of Pathology, Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
  • 2Associate Professor of Pathology, Department of Pathology, The Mount Sinai Medical Center, New York, New York
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Publication History

Publication Date:
16 December 2004 (online)

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ABSTRACT

Obesity-related liver disease, particularly nonalcoholic fatty liver disease and its more severe form nonalcoholic steatohepatitis, is being increasingly recognized as a common liver disease in developed countries and represents hepatic manifestation of the metabolic syndrome. Nonalcoholic steatohepatitis results in progressive fibrosis, cirrhosis, and end-stage liver disease, with its increased incidence of hepatocellular carcinoma. Liver biopsy remains the gold standard in detection, evaluation, staging, and grading of nonalcoholic steatohepatitis. Liver biopsy also provides an important tool to detect concomitant liver disease that may accelerate the progression of steatohepatitis in these patients.

Surgical or drug-induced weight loss has been documented to reduce the amount of inflammation, to induce regression of fibrosis, and, in some cases, to cause a reversal of cirrhosis in obese patients with steatohepatitis. Pretreatment or intraoperative liver biopsy should be performed to assess the presence of steatohepatitis, and stage and grade of steatohepatitis.

This article will discuss obesity-related liver diseases, focusing on pathologic features in liver biopsies from obese patients, obesity-related hepatocellular carcinoma, and the effect of weight loss treatment on histopathology.

KEYWORDS

Steatohepatitis - steatosis - obesity - nonalcoholic fatty liver disease - fibrosis - fat

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Arief SuriawinataM.D. 

Dartmouth Hitchcock Medical Center, Department of Pathology, One Medical Center Drive

Lebanon, NH 03756

Email: Arief.A.Suriawinata@hitchcock.org