Nonalcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease in many parts of the world. NAFLD can progress to nonalcoholic steatohepatitis (NASH) and result in cirrhosis and liver cancer. Despite NAFLD is common, there are a lot of knowledge gaps about this common disease including the progression from NAFLD to NASH and from fibrosis to cirrhosis, efficacious treatment strategies, etc.

In this study, we aim to investigate the clinical course and biomarkers associated with NAFLD in a group of obese patients with or without known history of NAFLD at baseline undergoing laparoscopic bariatric surgery. During laparoscopic surgery, subjects consented to participate will have liver biopsies performed under direct vision and sent for histological analysis and scoring. The patients will undergo comprehensive clinical and biochemical assessment before and after the surgical procedures.

The prevalence of NAFLD and clinical course of this group of patients with obesity will be assessed using histology as the gold standard. Clinical characteristics and biomarkers associated with NAFLD will be identified.

Inclusion Criteria:

• Age 18 years or above
• Chinese ethnicity
• Patient undergoing obesity surgery at The Prince of Wales Hospital

Exclusion Criteria:

• Endocrine causes of obesity
• Active uncontrolled psychiatric illness
• Active substance abuse
• Alcohol intake exceeding 30 grams per day in males or 20 grams per day in females
• Presence of other co-existing liver disease, as evidenced by known history of positive viral hepatitis serology
• History of decompensated liver disease
• Unlikely to comply with management protocol
• Failure to give consent

Patient undergoing obesity surgery at The Prince of Wales Hospital。