PD320 - HEPATIC HISTOLOGICAL ALTERATIONS IN PATIENTS WITH OBESITY: ASSOCIATION BETWEEN STEATOSIS AND FIBROSIS SEVERITY

PD320

HEPATIC HISTOLOGICAL ALTERATIONS IN PATIENTS WITH OBESITY: ASSOCIATION BETWEEN STEATOSIS AND FIBROSIS SEVERITY

M. García Duque^1,*, M. D. Ballesteros Pomar¹, E. González Arnáiz¹, D. G. Ariadel Cobo¹, A. M. Urioste Fondo¹, D. Carrascosa Lorente¹, M. D. C. Dameto Pons¹, M. Casado Rodríguez¹, L. Loroño Yagüe¹, M. Marcos Martín²

¹CAULE, León, ²CAUSA, Salamanca, Spain

Rationale: Obesity is strongly linked to metabolic dysfunction–associated steatotic liver disease (MASLD). In patients undergoing bariatric surgery, intraoperative liver biopsy allows direct assessment of hepatic injury. This study aimed to compare histological liver changes between patients with obesity and non-obese surgical controls, and to evaluate the relationship between steatosis and fibrosis.

Methods: This observational study included 94 patients with obesity and 30 non-obese controls. All underwent intraoperative liver biopsy. Histological analysis assessed steatosis, inflammation, ballooning, fibrosis, and calculated NAS and SAF scores. Clinical and biochemical data were also collected. Statistical significance was set at p < 0.05.

Results: Mean age was 45.2 ± 11.3 years in the obesity group and 54.0 ± 17.5 in controls. Obesity was associated with higher rates of diabetes (38.2%) and hypertension (52.1%). Steatosis was significantly more severe in patients with obesity: normal steatosis (<5%) occurred in 27.6% vs. 80% of controls, while severe steatosis (>66%) was seen in 25.5% vs. 3.3% (p < 0.001). Fibrosis was also more frequent: 41.5% of patients with obesity had no fibrosis vs. 80% of controls, whereas significant fibrosis (≥F2) was present in 26.5% vs. 6.6% (p = 0.001). No differences were found in inflammation or ballooning. NAS score differed significantly (p < 0.05), while SAF showed a trend (p = 0.06). Higher steatosis correlated with more severe fibrosis. Liver enzymes differed but did not reliably reflect histological severity.

Conclusion: Obesity is associated with more severe hepatic steatosis and fibrosis. The link between steatosis and fibrosis suggests a role in disease progression. Standard liver biochemistry does not accurately reflect histological damage, highlighting the importance of direct liver assessment.

Disclosure of Interest: None declared