Hepatic Steatosis and Morbid Obesity

One hundred and twenty-seven consecutive morbidly obese patients who presented for bariatric surgery underwent open wedge liver biopsy at the completion of their gastric restrictive procedure. All hepatic specimens were graded histologically for degrees of steatosis. Three-quarters of the patients had histological evidence of hepatic steatosis and in one-fifth this was severe and diffuse. No patient had histological evidence of fatty hepatitis, portal fibrosis, or cirrhosis. There was no significant correlation between the degree of obesity (measured as percentage over ideal weight), age, sex, or preoperative liver function tests and the degree of fatty change observed. Insufficient data were available to Implicate alcohol and poor protein nutrition in the etiology of the observed fatty liver change. Other factors such as diabetes mellitus or drugs were not etiologic factors in this series of patients.