P-31 NORMAL TRANSAMINASES IN OBESE PATIENTS WITH METABOLIC ASSOCIATED STEATOHEPATITIS

Abstract

Introduction: Metabolic associated fatty liver disease (MAFLD) and metabolic associated steatohepatitis (MASH) are the most frequent causes of chronic liver disease. Measurement of transaminases may not correlate with the severity of histopathological changes. Objective: We aimed to identify the frequency of normal and elevated transaminases in obese patients with MASH, as well as their clinical, biochemical and histological characteristics. Methods: A retrospective cross-sectional study was conducted in the bariatric surgery service of a private clinic. Obese patients older than 18 years with a body mass index (BMI) >30Kg/m2 and 2 co-morbidities undergoing a gastric sleeve surgery were included. Measurement of biochemical routine laboratory exams was performed. Insulin resistance was calculated using the homeostasis evaluation model (HOMA-IR). All patients underwent liver biopsies prior to surgery and the diagnosis of MASH was based on the Brunt criteria. Results: 159 obese patients with MASH were included, of which 47.2% had normal transaminases and 52.8% elevated transaminases. Factors associated with alteration in transaminases were: being male OR=4.02 (95% CI: 2.03-7.96; p50 IU/L OR=7.50 (95% CI: 3.40-16.56; p<0.01). The values of HOMA-IR and GGT were significantly higher in the group of high transaminases (p<0.01). Differences in the degree of fibrosis were not associated with transaminases levels. Conclusions: In conclusion we found that 47.2% of obese patients with MASH had normal transaminases. The degree of fibrosis was not associated with transaminases levels.