Non-alcoholic Fatty Liver Disease (NAFLD), the accumulation of fat in the liver (steatosis) related to obesity and glucose disturbances, can lead to severe liver disease and is an important contributor to metabolic disease. Many patients are at risk. Accurate screening tools to diagnose NAFLD without the need for a liver biopsy are urgently warranted. By prospectively and thoroughly assessing the presence of liver disease in obese patients we recently developed scoring systems that accurately predict liver disease but that need further validation. Specific biomarkers will be searched for to enable physicians to select, out of the large numbers of patients with obesity and diabetes, those who need further, more invasive testing and treatment. Furthermore, we previously showed that severe steatosis leads to changes in liver blood flows. We will study the impact of these changes on the evolution of the disease and on the risk of complications in surgery for obesity. Analysis of blood samples
obtained from the liver by a specific technical procedure will be performed to study the specific contribution of the liver to the health problems associated with obesity. Liver tissue samples will be examined to identify factors that contribute to disease. Finally, patients will be followed-up and re-examined after one year, in order to increase our understanding of the natural history of the disease, and to identify factors that not only predict disease severity but also its evolution.