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Q. I am morbidly obese with high ALT and AST. Do I have liver cirrhosis?

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Sep 25, 2020 and last reviewed on: Sep 30, 2020

Hi doctor,

I am a 35-year-old female. My height is 175 cm, and I weigh about 135 kg morbid obese. I am recently diagnosed with grade-2 fatty liver size 16.5 apart from that everything is normal in abdominal ultrasound.

LFT shows elevated bilirubin 1.7, ALT 93, AST 47, and GGT 60. All others are normal.

Platelet 378000.

Hemoglobin 15.

Viral markers are negative.

After 5 kg reduction of weight, repeated LFT after 25 days showed bilirubin 2.5, ALT 90, AST 53, and GGT 40. All the other values are normal.

Fibroscan 21 kPa.

Do I have liver cirrhosis? Or can this be reversed? I am in the process of weight loss. Doctor told me it is metabolic syndrome. I am also taking medication for diabetes and hypertension. Now my current weight is 126 kg. I am taking only vegetables, fruits, chicken breast and fish.

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Hi,

Welcome to icliniq.com.

I can understand your concern. According to your statement, you have been suffering from morbid obesity with grade-2 fatty liver. You are a known case of diabetes mellitus and hypertension. You have recently done fibroscan, and the rest has revealed that your TE scores 21.3 kPa suggesting F4 fibrosis with CAP Score 366 dB/m suggesting S3 Steatosis > 67% fat.

Fibroscan can measure fibrosis or scarring and steatosis or fatty change in the liver. Normal value is between 2-7 kPa. Your score is 21.3 kPa indicates stage 4 fibrosis or advanced liver scarring or cirrhosis. When fibrosis progresses to and destroys a liver structure, developing nodules is considered stage 4 fibrosis (F4) or cirrhosis.

It is usually irreversible, but lifestyle modification, weight reduction, and medications may improve the conditions. You can undergo a fasting lipid profile and do as needful by observing the parameters.


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